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Purpose <p>The aim of this study is to examine the incidence of receptor expression and the changes in subtypes observed between the primary breast cancer lesion and liver metastasis, and to investigate the impact of treatment patterns for various liver metastasis subtypes on patients’ survival outcomes.</p> Methods <p>A retrospective analysis was conducted on patients with breast cancer liver metastases at Peking University Cancer Hospital between 2008 and 2024.</p> Results <p>A total of 542 cases of breast cancer with liver metastasis were analyzed, of which 453 cases (83.6%) included complete receptor status records. The overall discordance rate between receptor expression in primary lesion and liver metastasis across the three subtypes was 23.6% (95% CI: 19.7–27.5), with a Kappa value of 0.55. The discordance rates for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression were 21.0% (95% CI: 17.2–24.7), 38.6% (95% CI: 34.1–43.1), and 10.8% (95% CI: 7.9–13.7), respectively, with corresponding Kappa values of 0.49, 0.27, and 0.68. Based on the receptor status of the liver metastasis, 321 cases (59.2%) were classified as HR+/HER2- type, 131 cases (24.2%) as HER2 + type, and 90 cases (16.6%) as triple-negative type. Significant differences were noted in median overall survival (OS) for liver metastasis among the three subtypes, measuring 58.0, 70.0, and 26.0 months, respectively (<i>P</i> &lt; 0.001).</p> Conclusion <p>Heterogeneity in expression of ER, PR, and HER2 is evident between primary breast cancer and liver metastatic foci. Prognostic outcomes differ markedly across various subtypes of liver metastases, with specific challenges observed in cases exhibiting ER-/PR+, low ER expression, and low HER2 expression.</p>

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Long-term survival outcomes and subtype variations between primary breast cancer and liver metastases in 542 patients with advanced breast cancer: insights from a real-world analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月7日

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  • Ying Yan,
  • Xinyu Gui,
  • Lijun Di,
  • Hanfang Jiang,
  • Xu Liang,
  • Bin Shao,
  • Guohong Song,
  • Huiping Li

摘要

Purpose

The aim of this study is to examine the incidence of receptor expression and the changes in subtypes observed between the primary breast cancer lesion and liver metastasis, and to investigate the impact of treatment patterns for various liver metastasis subtypes on patients’ survival outcomes.

Methods

A retrospective analysis was conducted on patients with breast cancer liver metastases at Peking University Cancer Hospital between 2008 and 2024.

Results

A total of 542 cases of breast cancer with liver metastasis were analyzed, of which 453 cases (83.6%) included complete receptor status records. The overall discordance rate between receptor expression in primary lesion and liver metastasis across the three subtypes was 23.6% (95% CI: 19.7–27.5), with a Kappa value of 0.55. The discordance rates for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression were 21.0% (95% CI: 17.2–24.7), 38.6% (95% CI: 34.1–43.1), and 10.8% (95% CI: 7.9–13.7), respectively, with corresponding Kappa values of 0.49, 0.27, and 0.68. Based on the receptor status of the liver metastasis, 321 cases (59.2%) were classified as HR+/HER2- type, 131 cases (24.2%) as HER2 + type, and 90 cases (16.6%) as triple-negative type. Significant differences were noted in median overall survival (OS) for liver metastasis among the three subtypes, measuring 58.0, 70.0, and 26.0 months, respectively (P < 0.001).

Conclusion

Heterogeneity in expression of ER, PR, and HER2 is evident between primary breast cancer and liver metastatic foci. Prognostic outcomes differ markedly across various subtypes of liver metastases, with specific challenges observed in cases exhibiting ER-/PR+, low ER expression, and low HER2 expression.