Recurrent node-positive breast cancer reveals distant metastasis in patients

Distant metastasis is present in all patients with node-positive breast cancer (NPBC) at the time of recurrence, reveals a study. Compared with diffusely metastatic (DM) patients, those with oligometastasis (OM) have shorter time to recurrence but longer overall survival (OS).

A team of investigators assessed the patterns and timing of recurrence with respect to survival in NPBC patients at greater risk for developing metastases. They performed a single-institution retrospective review of this population treated with trimodality therapy to obtain the following data: patient and disease characteristics, recurrence location, method of detection, and survival outcome.

Finally, the investigators identified factors associated with recurrence by conducting univariate and multivariate analyses.

Between 2008 and 2019, 94 patients with NPBC treated at a safety-net hospital were identified. Of these, 21 developed recurrence and were categorized into OM (n=10; ≤5 lesions) or DM (n=11) subgroups.

Median recurrence-free survival was 18 months in OM and 36 months in DM. Median OS for OM was not reached, while that for DM was 57 months. Four patients with OM progressed to diffuse disease over a median period of 17 months, with median survival of 57 months thereafter.

All patients who had recurrence presented with distant metastases on initial detection, with bone (n=14) being the most common site. Computed tomography detected most of these recurrences (n=13), with the majority of the disease situated within the thorax region.

“This study highlights improved surveillance imaging for timely detection of OM breast cancer that may yet be amenable to aggressive local salvage therapy to prevent progression to diffuse disease,” the investigators said.