Journal Article

A comprehensive evaluation of de novo metastatic breast cancer trends by subtype from the Dallas Metastatic Cancer Study

Iyer, Ruchita, Uwera, Giselle, Okanlawon, Priscilla, Engidaw, Yemariamwork, Lim, Mir, Ladner, Jonathan, Reddy, Sangeetha M., Lei, Katherine, Brown, Ariel, Huang, Shao-Po, Cao, Meng, Spanbauer, Danielle, Chan, Isaac S., Wu, Nathaniel, Hodgdon, Christine, Gao, Ang, Oh, Jaeyoung, Moscowitz, Anna, Xu, Lily, Mohta, Sakshi, Chang, Hannah L., Weiss, Ariana, McArthur, Heather L., Chinea, Luis, Maues, Julia, Olivo, Reynaldo, Bansal, Rani

2025

Overview

Background The Dallas Metastatic Cancer Study is a clinical database established to examine local trends associated with the diagnosis and treatment of de novo metastatic breast cancer and identify factors for further evaluation. Clinical characteristics of patients with de novo metastatic breast cancer are often underreported in the literature. Methods We report data from 2010 to 2021 for patients with de novo metastatic breast cancer along with the impact of clinical variables such as age, BMI, race and ethnicity, insurance status, hypertension, diabetes, and site of metastasis with survival analysis with respect to subtype. Results Black race (HR 2.07, 95% CI 1.56–2.74), public insurance (HR 1.64, 95% CI 1.23–2.18), no insurance (HR 1.69, 95% CI 1.24–2.31), hypertension (HR 1.50, 95% CI 1.18–1.91), diabetes (HR 1.69, 95% CI 1.24–2.31), and visceral metastases including brain (HR 1.68, 95% CI 1.20–2.36), liver (HR 1.80, 95% CI 1.40–2.30), and lung (HR 1.50, 95% CI 1.17–1.92) were associated with increased mortality and remained significant when controlled for subtype. In the multivariate analysis, diabetes (HR 1.74, 95% CI 1.22–2.49) and presence of liver metastases (HR 1.97, 95% CI 1.43–2.49) remained independently associated with decreased overall survival regardless of subtype and other variables. Patients diagnosed at 40 and younger were less likely to have hypertension and diabetes, more likely to be Hispanic, and showed distinct subtype distributions compared to those diagnosed at older ages. Conclusions Future work will focus on these associations at the patient level to identify targets for intervention. Plain language summary The Dallas Metastatic Cancer Study aims to better understand metastatic breast cancer by examining local trends in diagnosis and treatment. The study analyzed data from 2010 to 2021 and specifically focused on patients with a metastatic breast cancer diagnosis at first presentation. The study evaluated how factors such as age, BMI, race, insurance status, and co-existing medical conditions like hypertension and diabetes affected survival. The results show that Black patients, those with public or no insurance, those with specific metastases (i.e., liver, brain, lung) had worse survival outcomes. These outcomes underscore the areas where targeted interventions could improve patient outcomes. Chang, Cao et al. examine local trends associated with the diagnosis and treatment of de novo metastatic breast cancer. Findings show that black race, hypertension, diabetes, as well as the presence of visceral metastases are associated with a worse prognosis.

• Publisher: Nature Publishing Group UK,Springer Nature B.V,Nature Portfolio
• Subject: 631/67 / 692/308 / Age groups / Biomarkers / Biopsy / Body mass index / Breast cancer / Diabetes / Ethnicity / Hypertension / Medical diagnosis / Medical prognosis / Medicine / Medicine & Public Health / Metastasis / Mortality / Patients / Regression analysis / Tumors / Womens health