Abstract 342P
Background
The impact of regular follow-up on the clinical outcome after recurrent breast cancer (rBC) is still debated. Aim of this study is to describe the modalities of detection of inoperable rBC that could serve to design prospective studies that evaluate the prognostic impact of surveillance.
Methods
We retrospectively analyzed a consecutive series of 169 pts with rBC detected between 2012-2016 at the Department of Oncology of Udine, Italy. Pts with de novo advanced BC were not eligible. Baseline features at the diagnosis of early BC (eBC) and modalities of detection of rBC were analyzed.
Results
The main disease characteristics at the diagnosis of eBC were: pT1 (46%), N+ (57%), Ki67≥14% (60%), luminal HER2-neg subgroup (63%), triple negative (TN) subgroup (17%), HER2-pos subgroup (15%). Of note, 25% received a radical resection for loco-regional recurrence. The median time to recurrence (TTR) was 66.6 months. At the diagnosis of rBC, 53% of pts had ECOG PS 0, 54% had visceral metastases, 2% with visceral crisis, and 76% had less than 3 metastatic sites involved. Among symptomatic pts (46%), 40% reported pain, 21% thoracic symptoms, 12% neurological symptoms, 8% constitutional symptoms and 19% had locoregional symptoms/signs of relapse. The majority of rBC in asymptomatic pts was detected by radiological exams (47%), followed by serum markers (34%) and other changes in blood tests (7%). Of note, 43%, 14% and 33% of rBC were intercepted by oncologist, general practitioner and other specialists, respectively. rBC diagnosis was made during a scheduled oncological follow-up visit in 30% of cases. Clinical symptoms were detected mainly in Ki67≥14% pts (OR 2.75, 95%CI 1.01-7.51, p=0.04), while biochemical alterations were mainly evident in ER-pos (OR 4.61, 95%CI 1.01-21.22, p=0.05). These finding were not confirmed in the multivariate logistic regression model. None of analyzed factors were associated with detection through radiological exams.
Conclusions
These findings provide information about the modality of detection of rBC. Albeit purely descriptive, they could be helpful in drawing prospective randomized studies to explore the prognostic impact of surveillance programmes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
M. Mansutti: Advisory/Consultancy: Novartis; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Eli Lilly. F. Puglisi: Honoraria (self): MSD; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Roche; Honoraria (self), Advisory/Consultancy: Eli Lilly; Honoraria (self): Takeda; Honoraria (self): Pfizer; Advisory/Consultancy: Amgen; Advisory/Consultancy: Novartis; Advisory/Consultancy: Pierre; Research grant/Funding (self): AstraZeneca; Research grant/Funding (self): Eisai; Travel/Accommodation/Expenses: Celgene; Travel/Accommodation/Expenses: Servier. G. Fasola: Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Eli Lilly S.p.A.; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bristol-Myers Squibb; Travel/Accommodation/Expenses: Merck Sharp and Dohme S.p.A.; Travel/Accommodation/Expenses: Boehringer-Ingelheim S.p.A.; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Servier Italia S.p.A.; Speaker Bureau/Expert testimony: AstraZeneca. A.M. Minisini: Advisory/Consultancy: Novartis; Advisory/Consultancy: MSD; Advisory/Consultancy: Pierre Fabre. All other authors have declared no conflicts of interest.