Breast Cancer Metastasis: Markers and Models

Britta Weigelt; Johannes L. Peterse; Laura J. van't Veer

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In This Article

Clinical Features of Breast Cancer Metastasis

Breast cancer is a clinically heterogeneous disease. Approximately 10-15% of patients with breast cancer have an aggressive disease and develop distant metastases within 3 years after the initial detection of the primary tumour. However, the manifestation of metastases at distant sites 10 years or more after the initial diagnosis is also not unusual.[11] Patients with breast cancer are therefore at risk of experiencing metastasis for their entire lifetime. The heterogeneous nature of breast cancer metastasis makes it difficult not only to define cure for this disease, but also to assess risk factors for metastasis.

A wide range of histopathological subtypes of invasive breast cancer have been identified, of which the invasive ductal carcinomas, defined as a type of cancer 'not classified into any of the other categories of invasive mammary carcinoma', represent the largest group[12] ( Table 1 ; online supplementary information S1 (figure)). Although some of the morphologically distinct, special types of breast tumour, which represent 5-10% of all breast cancers, have certain favourable prognostic features, histological typing in general is only a weak prognostic marker of metastasis risk.[12]

Once disseminated, metastases from carcinoma of the breast are formed in various organs. The common sites for metastatic spread are bone, lung and liver (reviewed in Ref. 13) (Figure 1).

Most common metastasis sites of breast cancer at autopsy. Primary breast cancer cells metastasize through the blood vessels to various distant organs, preferentially, to the lung, liver and bones. Patients frequently develop metastases at multiple sites. Data adapted from Ref. 13.

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