FACTORS INFLUENCING THE DISTRIBUTION OF METASTASES AND SURVIVAL IN METASTATIC BREAST-CARCINOMA

A total of 370 patients with metastatic breast carcinoma who had been followed at Hacettepe Oncology Department between 1980 and 1991 were r etrospectively analyzed for the factors influencing the distribution o f metastases and survival. Median age was 47 years. Radical or modifie d radical mastectomies were performed in 199 (53.8%). Infiltrative duc tal carcinoma was the most common pathologic subtype (69.4%). In 191 p atients who were evaluated for estrogen receptor (ER) status, 101 (52. 9%) were positive and 90 (47.1%) were negative. The distribution of fi rst metastases did not differ between the soft tissue, bone, and visce ral sites. The second, third, and fourth metastases were more common i n visceral sites (p < 0.05). ER and menopausal status did not affect d istribution. Mortality rate was significantly lower in the group havin g the first metastasis to the bone (p < 0.05). Of interest, first meta stases were predominantly found in visceral sites in patients having r adical or modified radical mastectomies (p < 0.05). Response to therap y, presence of initial metastases, axillary status, and age were the i mportant factors influencing the overall survival in univariate analys is, whereas response to therapy, ER status, age, and presence of initi al metastases were the important factors according to the multivariate analysis.