Clinical features and prognostic analysis of 117 breast cancer patients with first metastasis to the lung

Objective: To analyze the prognosis-related factors of breast cancer patients with first metastasis to the lung. Methods: One-hundred and seventeen breast cancer patients with first metastasis to the lung were included in this study from January 2001 through December 2008. All these patients had undergone breast cancer surgery. The clinical and pathological information of the patients was collected. All the patients received a follow-up, and the factors related to the survival were evaluated by using univariate and multivariate analyses. Results: The median overall survival after lung metastases was 32 (2-107) months, the median time to progression was 13 (1-76) months, and the median overall survival after breast cancer surgery was 66 (8-169) months. The five-year survival rates after lung metastases were 65.4%, 33.2%, 30.2% and 19.2%, respectively (P = 0.006) and the two-year progression-free survival rates were 64.6%, 49.3%, 48.0% and 30.7%, respectively (P = 0.005) for four different molecular subtypes which were luminal A, luminal B, HER-2 (human epidermal growth factor receptor 2)/neu overexpression and triple negative. In univariate analysis, the factors of molecular subtypes, disease-free interval, liver metastases, brain metastases, number of lung metastases, location of lung metastases, size of the largest metastasis and cycles of chemotherapy after lung metastases were associated with the prognosis of breast cancer patients with first metastasis to the lung (P < 0.05). In multivariate analysis, the factors of disease-free interval, number of lung metastases, location of lung metastases and size of the largest metastasis were independent predictors of poor survival after lung metastases (P < 0.05). Conclusion:The prognosis of breast cancer patients with first metastasis to the lung is associated with the nature of the lung metastases. The findings of this study suggest that early diagnosis of lung metastases play an important role in the treatment of lung metastases in breast cancer. DOI:10.3781/j.issn.1000-7431.2012.11.009