Metastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysis
Abstract Background To assess proportions of metastatic recurrence in women initially diagnosed with non-metastatic breast cancer by stage at diagnosis, breast cancer subtype, calendar period and age. Methods A systematic search of MEDLINE and Web of Science databases (January 2010–12 May 2022) was...
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2024-11-01
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| Series: | Breast Cancer Research |
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| Online Access: | https://doi.org/10.1186/s13058-024-01881-y |
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| author | Eileen Morgan Colette O’Neill Richa Shah Oliver Langselius Yaqi Su Clara Frick Hanna Fink Aude Bardot Paul M. Walsh Ryan R. Woods Lou Gonsalves Jan F. Nygård Serban Negoita Esmeralda Ramirez-Pena Karen Gelmon Nicoleta Antone Miriam Mutebi Sabine Siesling Fatima Cardoso Julie Gralow Isabelle Soerjomataram Melina Arnold |
| author_facet | Eileen Morgan Colette O’Neill Richa Shah Oliver Langselius Yaqi Su Clara Frick Hanna Fink Aude Bardot Paul M. Walsh Ryan R. Woods Lou Gonsalves Jan F. Nygård Serban Negoita Esmeralda Ramirez-Pena Karen Gelmon Nicoleta Antone Miriam Mutebi Sabine Siesling Fatima Cardoso Julie Gralow Isabelle Soerjomataram Melina Arnold |
| author_sort | Eileen Morgan |
| collection | DOAJ |
| description | Abstract Background To assess proportions of metastatic recurrence in women initially diagnosed with non-metastatic breast cancer by stage at diagnosis, breast cancer subtype, calendar period and age. Methods A systematic search of MEDLINE and Web of Science databases (January 2010–12 May 2022) was conducted. Studies reporting the proportion of distant metastatic recurrence in women with non-metastatic breast cancer were identified and outcomes and characteristics were extracted. Risk of bias was assessed independently by two reviewers. Random-effects meta-analyses of proportions were used to calculate pooled estimates and 95% confidence intervals (CIs). Results 193 studies covering over 280,000 patients were included in the main analysis. Pooled proportions of metastatic recurrence increased with longer median follow-up time from 12.2% (95% CI 10.5–14.0%) at 1–4 years post diagnosis, 14.3% (95% CI 12.9–15.7%) at 5–9 years to 23.3% (95% CI 20.1–26.8) at 10 years or more. Regional variation was observed with pooled estimates ranging from 11.0% (95% CI 8.5–13.7%) in Europe to 26.4% (95% CI 16.7–37.4%) in Africa (1–4 years follow-up). Proportions of recurrence were higher in studies with diagnosis before 2000 (22.2%, 95% CI 15.1–30.3) compared to studies with diagnosis from 2000 onwards (12.8%, 95% CI 11.7–14.0). At 1–4 years median follow-up, pooled proportions of metastatic recurrence were higher in women with hormone receptor negative (15.2%, 95% CI 12.0–18.7%) compared with receptor positive disease (9.6%, 95% CI 6.2–13.6%) and in women with locally advanced (33.2%, 95% CI 24.7–42.3%) relative to early disease at initial diagnosis (4.8%, 95% CI 2.5–7.8%). Proportions were higher in those under 50 years compared with 70+ years, 18.6% (95% CI 15.9–21.4%) versus 13.3% (95% CI 9.2, 18.0%), respectively. Heterogeneity was high in all meta-analyses and results should be interpreted with caution. Conclusions Higher proportions of metastatic recurrence in patients initially diagnosed at an advanced stage and in earlier calendar period emphasises the importance of early detection and treatment advancements. As the global number of breast cancer survivors increases, research and health policy efforts should be directed towards timely diagnosis and access to effective treatments and care. Study registration: PROSPERO CRD42022314500. |
| format | Article |
| id | doaj-art-52aed00f20ba405db3b38f7835f28bea |
| institution | DOAJ |
| issn | 1465-542X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
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| series | Breast Cancer Research |
| spelling | doaj-art-52aed00f20ba405db3b38f7835f28bea2025-08-20T02:49:12ZengBMCBreast Cancer Research1465-542X2024-11-0126112310.1186/s13058-024-01881-yMetastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysisEileen Morgan0Colette O’Neill1Richa Shah2Oliver Langselius3Yaqi Su4Clara Frick5Hanna Fink6Aude Bardot7Paul M. Walsh8Ryan R. Woods9Lou Gonsalves10Jan F. Nygård11Serban Negoita12Esmeralda Ramirez-Pena13Karen Gelmon14Nicoleta Antone15Miriam Mutebi16Sabine Siesling17Fatima Cardoso18Julie Gralow19Isabelle Soerjomataram20Melina Arnold21Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO)National Cancer Registry IrelandCancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO)Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO)Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO)Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO)Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO)Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO)National Cancer Registry IrelandBC CancerConnecticut Department of Public Health, Connecticut Tumor RegistryCancer Registry of Norway, Norwegian Institute of Public HealthData Quality, Analysis, and Interpretation Branch, Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, National Institutes of HealthData Quality, Analysis, and Interpretation Branch, Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, National Institutes of HealthBC CancerBreast Cancer Center, Institute of Oncology “Ion Chiricuta”Breast Surgical Oncology, Aga Khan University HospitalDepartment of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL)Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation and ABC Global AllianceAmerican Society of Clinical OncologyCancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO)Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO)Abstract Background To assess proportions of metastatic recurrence in women initially diagnosed with non-metastatic breast cancer by stage at diagnosis, breast cancer subtype, calendar period and age. Methods A systematic search of MEDLINE and Web of Science databases (January 2010–12 May 2022) was conducted. Studies reporting the proportion of distant metastatic recurrence in women with non-metastatic breast cancer were identified and outcomes and characteristics were extracted. Risk of bias was assessed independently by two reviewers. Random-effects meta-analyses of proportions were used to calculate pooled estimates and 95% confidence intervals (CIs). Results 193 studies covering over 280,000 patients were included in the main analysis. Pooled proportions of metastatic recurrence increased with longer median follow-up time from 12.2% (95% CI 10.5–14.0%) at 1–4 years post diagnosis, 14.3% (95% CI 12.9–15.7%) at 5–9 years to 23.3% (95% CI 20.1–26.8) at 10 years or more. Regional variation was observed with pooled estimates ranging from 11.0% (95% CI 8.5–13.7%) in Europe to 26.4% (95% CI 16.7–37.4%) in Africa (1–4 years follow-up). Proportions of recurrence were higher in studies with diagnosis before 2000 (22.2%, 95% CI 15.1–30.3) compared to studies with diagnosis from 2000 onwards (12.8%, 95% CI 11.7–14.0). At 1–4 years median follow-up, pooled proportions of metastatic recurrence were higher in women with hormone receptor negative (15.2%, 95% CI 12.0–18.7%) compared with receptor positive disease (9.6%, 95% CI 6.2–13.6%) and in women with locally advanced (33.2%, 95% CI 24.7–42.3%) relative to early disease at initial diagnosis (4.8%, 95% CI 2.5–7.8%). Proportions were higher in those under 50 years compared with 70+ years, 18.6% (95% CI 15.9–21.4%) versus 13.3% (95% CI 9.2, 18.0%), respectively. Heterogeneity was high in all meta-analyses and results should be interpreted with caution. Conclusions Higher proportions of metastatic recurrence in patients initially diagnosed at an advanced stage and in earlier calendar period emphasises the importance of early detection and treatment advancements. As the global number of breast cancer survivors increases, research and health policy efforts should be directed towards timely diagnosis and access to effective treatments and care. Study registration: PROSPERO CRD42022314500.https://doi.org/10.1186/s13058-024-01881-ySystematic reviewMeta-analysisBreast cancerRecurrenceMetastasis |
| spellingShingle | Eileen Morgan Colette O’Neill Richa Shah Oliver Langselius Yaqi Su Clara Frick Hanna Fink Aude Bardot Paul M. Walsh Ryan R. Woods Lou Gonsalves Jan F. Nygård Serban Negoita Esmeralda Ramirez-Pena Karen Gelmon Nicoleta Antone Miriam Mutebi Sabine Siesling Fatima Cardoso Julie Gralow Isabelle Soerjomataram Melina Arnold Metastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysis Breast Cancer Research Systematic review Meta-analysis Breast cancer Recurrence Metastasis |
| title | Metastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysis |
| title_full | Metastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysis |
| title_fullStr | Metastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysis |
| title_full_unstemmed | Metastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysis |
| title_short | Metastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysis |
| title_sort | metastatic recurrence in women diagnosed with non metastatic breast cancer a systematic review and meta analysis |
| topic | Systematic review Meta-analysis Breast cancer Recurrence Metastasis |
| url | https://doi.org/10.1186/s13058-024-01881-y |
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