Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 34 min ago
Peer-reviewedCC BY 4.0Journal of Cancer Research and Clinical Oncology

Determinants of synchronous and metachronous metastatic breast cancer (2000–2024)–an analysis based on data from German cancer registries

  • M. E. Lacruz1
  • A. Bedir1
  • I. Wittenberg1
  • S. Thies1
  • C. Schneider2
  • F. Reinwald3
  • W. Hoffmann4
  • S. Faißt5
  • B. Franke6
  • K. Kleihues6
  • S. R. Zeissig6,7,8
  • M. Klinkhammer-Schalke9
3 more authors
  • M. Gerken9
  • E. C. Sturm-Inwald10,11
  • A. Ignatov12
12 affiliations
  1. 1Cancer Registry Saxony-Anhalt, Magdeburg, Germany
  2. 2Clinical-Epidemiological Cancer Registry Brandenburg-Berlin, Cottbus, Germany
  3. 3Cancer Registry of Rhineland-Palatinate in the Institute for Digital Health Data, Mainz, Germany
  4. 4Cancer Registry Mecklenburg-Western Pomerania, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
  5. 5Institute for Health Services Research at the Oncology Center Stuttgart E.V., Stuttgart, Germany
  6. 6Association of German Tumor Centers (ADT), Network for Care, Quality and Research in Oncology, Berlin, Germany
  7. 7Institute of Clinical Epidemiology and Biometry, Julius Maximilian University of Würzburg, Würzburg, Germany
  8. 8Bavarian Cancer Registry-Regional Center Würzburg, Bavarian Health and Food Safety Authority, Würzburg, Germany
  9. 9Tumor Center Regensburg, Center for Quality Management and Health Care Research of the University, Regensburg, Germany
  10. 10Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
  11. 11Bavarian Cancer Registry, Bavarian Health and Food Safety Authority, Regensburg, Germany
  12. 12University Hospital for Obstetrics and Gynecology, Medical Faculty, Otto-Von-Guericke University, Magdeburg, Germany
Read full textPDFDOICite

Abstract

Purpose To investigate the association of molecular breast cancer subtypes with the timing and organ-specific patterns of metastatic disease. Methods We analyzed data from nine German regional cancer registries, including 172 512 women diagnosed with invasive breast cancer between January 2000 and March 2024. Patients were classified as having no metastases, synchronous metastases (within three months of diagnosis), or metachronous metastases. Factors associated with synchronous metastases were assessed using multivariable binary logistic regression adjusted for confounders. Time to first metachronous metastasis was analyzed using multivariable Cox regression. Timing and organ-specific metastatic patterns were compared across subtypes. Results Molecular subtypes were associated with both synchronous and metachronous metastatic disease. Compared with HR+/HER2− tumors, HR−/HER2+ tumors had the highest odds of synchronous metastasis (adjusted OR [aOR] 1.69, 95%CI 1.57 – 1.83), whereas HR−/HER2− tumors showed no increased odds (aOR 0.96, 95%CI 0.90 – 1.02). In contrast, HR−/HER2− tumors had the highest risk of metachronous metastases (adjusted HR [aHR] 1.48, 95%CI 1.41 – 1.55), while HR+/HER2+ tumors showed a lower risk than HR+/HER2− tumors (aHR 0.88, 95%CI 0.84–0.93). Cumulative incidence increased between 5 and 10 years after diagnosis, with late risk among HR-positive tumors. Metastatic patterns differed by subtype, with HR+/HER2− tumors showing predominantly bone metastases, and HR−/HER2− tumors exhibiting more frequent visceral and central nervous system (CNS) involvement. Conclusion Molecular subtypes influence the timing and distribution of metastatic breast cancer. HER2-positive tumors are associated with synchronous metastatic presentation, whereas HR−/HER2− tumors showed the highest risk of metachronous metastasis. These findings support subtype-specific risk assessment and surveillance strategies.

Related

  1. Metachronous Metastatic Invasive Breast Carcinoma and Metastatic Small Cell Carcinoma Clinically and Radiologically Favoured to Be of Pulmonary Origin: A Case Report
    Adeline-Roxana Bucur, Alexandru Cristian Cindrea, Petra Curescu +3
    Diagnostics (Basel, Switzerland)Peer-reviewedCC BYFull textGeneral medicineEurope PMC
  2. Synchronous Early Gastric Adenocarcinoma and Cervical Carcinoma of Unknown Primary with Metachronous Hepatocellular Carcinoma: A Case Report.
    Yupeng Li, Hongyan Zhao, Chunqing Fu +4
    OncoTargets and therapyPeer-reviewedCC BY-NCFull textEpidemiology & public healthEurope PMC
  3. Healthcare Inequities and Structural Racism as Determinants of Treatment and Survival among Individuals Recently Diagnosed with Cervical Cancer from Two Diverse Population-Based Cancer Registries: The ACHIEVE Study
    Jennifer Tsui, Heather Wurtz, Amber Rockson +16
    Behavioral medicine (Washington, D.C.)Peer-reviewedCC BY-NC-NDFull textEpidemiology & public healthPMC
  4. Development of an algorithm to support cancer registry registration by identifying patients with metachronous metastases after primary breast cancer
    L. de Munck, H. Buisman, J. Verloop +1
    ESMO Real World Data and Digital OncologyPeer-reviewedCC BY-NC-NDFull textOncologyDOAJ
  5. Radiobiological evaluation of hypofractionated vs. conventional VMAT for synchronous bilateral breast cancer: a focus on regional nodal irradiation
    Jiyong Zhang, Danli Hong, Chunyan Deng
    Frontiers in medicinePeer-reviewedCC BYFull textGeneral medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{lacruz2026determinants,
  title = {{Determinants of synchronous and metachronous metastatic breast cancer (2000–2024)–an analysis based on data from German cancer registries}},
  author = {M. E. Lacruz and A. Bedir and I. Wittenberg and S. Thies and C. Schneider and F. Reinwald and W. Hoffmann and S. Faißt and B. Franke and K. Kleihues and S. R. Zeissig and M. Klinkhammer-Schalke and M. Gerken and E. C. Sturm-Inwald and A. Ignatov},
  journal = {Journal of Cancer Research and Clinical Oncology},
  year = {2026},
  month = nov,
  doi = {10.1007/s00432-026-06631-5},
  url = {https://doi.org/10.1007/s00432-026-06631-5},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Determinants of synchronous and metachronous metastatic breast cancer (2000–2024)–an analysis based on data from German cancer registries
AU  - M. E. Lacruz
AU  - A. Bedir
AU  - I. Wittenberg
AU  - S. Thies
AU  - C. Schneider
AU  - F. Reinwald
AU  - W. Hoffmann
AU  - S. Faißt
AU  - B. Franke
AU  - K. Kleihues
AU  - S. R. Zeissig
AU  - M. Klinkhammer-Schalke
AU  - M. Gerken
AU  - E. C. Sturm-Inwald
AU  - A. Ignatov
PY  - 2026
DA  - 2026/11/04
JO  - Journal of Cancer Research and Clinical Oncology
DO  - 10.1007/s00432-026-06631-5
UR  - https://doi.org/10.1007/s00432-026-06631-5
AB  - Purpose To investigate the association of molecular breast cancer subtypes with the timing and organ-specific patterns of metastatic disease. Methods We analyzed data from nine German regional cancer registries, including 172 512 women diagnosed with invasive breast cancer between January 2000 and March 2024. Patients were classified as having no metastases, synchronous metastases (within three months of diagnosis), or metachronous metastases. Factors associated with synchronous metastases were assessed using multivariable binary logistic regression adjusted for confounders. Time to first metachronous metastasis was analyzed using multivariable Cox regression. Timing and organ-specific metastatic patterns were compared across subtypes. Results Molecular subtypes were associated with both synchronous and metachronous metastatic disease. Compared with HR+/HER2− tumors, HR−/HER2+ tumors had the highest odds of synchronous metastasis (adjusted OR [aOR] 1.69, 95%CI 1.57 – 1.83), whereas HR−/HER2− tumors showed no increased odds (aOR 0.96, 95%CI 0.90 – 1.02). In contrast, HR−/HER2− tumors had the highest risk of metachronous metastases (adjusted HR [aHR] 1.48, 95%CI 1.41 – 1.55), while HR+/HER2+ tumors showed a lower risk than HR+/HER2− tumors (aHR 0.88, 95%CI 0.84–0.93). Cumulative incidence increased between 5 and 10 years after diagnosis, with late risk among HR-positive tumors. Metastatic patterns differed by subtype, with HR+/HER2− tumors showing predominantly bone metastases, and HR−/HER2− tumors exhibiting more frequent visceral and central nervous system (CNS) involvement. Conclusion Molecular subtypes influence the timing and distribution of metastatic breast cancer. HER2-positive tumors are associated with synchronous metastatic presentation, whereas HR−/HER2− tumors showed the highest risk of metachronous metastasis. These findings support subtype-specific risk assessment and surveillance strategies.
SN  - 1432-1335
SN  - 0171-5216
ER  -