Prognostic Differences And Initial Metastatic Tendency In Breast Cancer Patients With Different Family History Of Malignancy

Objective: Despite major advances in the treatment of breast cancer over the past few decades,the prognosis of most patients with distant metastasis remains poor.Although FH of malignant neoplasm is a risk factor for cancer incidence,it is unclear whether FH is associated with the risk of distant metastasis as well as the PFS and OS.Therefore,this study aimed to determine the association between an FH and metastatic patterns,which has not been evaluated in any study before.We focused on investigating whether patients with different family histories of malignant tumors had different tendencies for their initial organ metastasis and determined their effects on PFS.Methods: An FH of cancer is self-reported through interviews at the time of cancer diagnosis.The inclusion criteria were strictly controlled for invasive breast cancer patients who had received standard treatment.The sites of metastasis included in the study were local recurrence,as well as the contralateral breast,bones,brain,liver,lungs,bones,and digestive system.The chi-squared test or Fisher’s exact test was used for categorical data and descriptive variable statistics,and the t-test for comparison between intra-and inter-group samples.After univariate and multivariate analyses,independent predictors of distant metastasis were screened.The overall data were analyzed via univariate analysis,and the statistically significant(P <0.05)variables were selected for multivariate analysis,which was performed to screen out the independent predictors for the risk of distant metastasis.The same method was used to further examine the relationship between various metastatic sites and various family histories,to determine whether the FH was an independent predictor.Results: On univariate analysis,the variable of FH was significant(P =0.016).Family history of malignancy may serve as a breast cancer metastasis risk predictor.Multivariate analysis of variables and logistic regression analysis showed the following results:(1)An FH of lung cancer was negative correlated with bone metastasis,and An FH of lung cancer was negative correlated with lymph node and contralateral breast cancer recurrence.(2)An FH of breast cancer was positively correlated with lung metastasis.An FH of breast cancer and brain metastasis showed a positive correlation.An FH of breast cancer was positively correlated with lymph node and contralateral breast cancer recurrence.(3)Digestive tract tumors were positively correlated with bone metastasis,while there was no significant correlation between liver metastasis and FH.Conclusion: Family history of malignancy can predict breast cancer metastatic tendency.An FH of breast cancer subtypes was associated with different metastatic patterns and have different effects on prognosis.