Affiliations 

  • 1 Julius Centre University of Malaya, Centre for Evidence Based Medicine and Clinical Epidemiology, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Lembah Pantai, Kuala Lumpur, Malaysia
  • 2 Saw Swee Hock School of Public Health, National University of Singapore, MD3, 16 Medical Drive, Singapore 117597
  • 3 Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
  • 4 Department of Surgery, Faculty of Medicine, University of Malaya, 50603 Lembah Pantai, Kuala Lumpur, Malaysia
  • 5 Institution of Medical Epidemiology and Biostatistics, Karolinska Instituet, Nobels Väg 12A, 171 77 Stockholm, Sweden
  • 6 National Cancer Centre Singapore, 11 Hospital Dr, Singapore 169610
  • 7 National Clinical Research Centre, Level 3, Dermatology Block, Kuala Lumpur Hospital, 50586 Jalan Pahang, Kuala Lumpur, Malaysia
  • 8 Department of Hematology Oncology, National University Cancer Institute, National University Health System, Singapore 119228
Sci Rep, 2015;5:16252.
PMID: 26536962 DOI: 10.1038/srep16252

Abstract

Up to 25% of breast cancer patients in Asia present with de novo metastatic disease. We examined the survival trends of Asian patients with metastatic breast cancer over fifteen years. The impact of changes in patient's demography, tumor characteristics, tumor burden, and treatment on survival trend were examined. Patients with de novo metastatic breast cancer from three hospitals in Malaysia and Singapore (N = 856) were grouped by year of diagnosis: 1996-2000, 2001-2005 and 2006-2010. Step-wise multivariable Poisson regression was used to estimate the contribution of above-mentioned factors on the survival trend. Proportions of patients presenting with metastatic breast cancer were 10% in 1996-2000, 7% in 2001-2005, and 9% in 2006-2010. Patients in 2006-2010 were significantly older, appeared to have higher disease burden, and received more chemotherapy, endocrine therapy, and surgery of primary tumor. The three-year relative survival in the above periods were 20·6% (95% CI: 13·9%-28·2%), 28·8% (95% CI: 23·4%-34·2%), and 33·6% (95% CI: 28·8%-38·5%), respectively. Adjustment for treatment considerably attenuated the relative excess risk of mortality in recent years, compared to other factors. Substantial improvements in survival were observed in patients with de novo metastatic breast cancer in this study.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.