Breast Cancer Metastases and Survival Outcomes: Wenbin Zhou, MD, PhD

Wenbin Zhou, MD, PhD.

Approximately 3%–8% of patients with newly diagnosed breast cancer have synchronous distant metastases, which are associated with a poor prognosis. Because therapeutic strategies are guided by the status of lymph node metastases, accurate assessment is necessary in order to select the appropriate treatment for different patients. In a study recently published in JAMA Network Open, a team of investigators found that patients with distant metastases experienced significantly worse survival compared with those with ipsilateral supraclavicular lymph node (ISLN) metastases; however, patients with distant lymph node (DLN) metastases experienced similar overall and breast cancer–specific survival outcomes. Additionally, DLN metastases were associated with a significant increase in overall survival, suggesting that DLN metastases may be indicative of regional disease with potential benefit from locoregional therapies. In this interview with Oncology Data Advisor, Wenbin Zhou, MD, PhD, Assistant Professor in the Department of Breast Surgery at the First Affiliated Hospital of Nanjing Medical University and the study’s senior author, discusses the significance of these results and shares how they should impact treatment strategies for patients with metastatic breast cancer.

Can you comment on the significance of your findings regarding the difference in breast cancer survival outcomes among patients with DLN versus ISLN metastases?

Wenbin Zhou, MD, PhD: This is the first study, with the largest sample size, that compares the differences in real-world survival among patients with breast cancer who have DLN, ISLN, and distant metastases. We found direct evidence that breast cancer with DLN metastases may in fact be a curable disease with a significantly better prognosis compared with stage IV disease, excluding stage IV with DLN metastases. Patients with DLN metastases receiving locoregional treatment experienced significantly improved survival. Breast cancer with DLN metastases may therefore be a regional disease, not a metastatic disease.

How do you think that your results should impact current clinical practice for patients with breast cancer?

Dr. Zhou: Based on the study, we found that primary surgery and radiotherapy significantly improved survival for patients with DLN metastases. In clinical practice, we recommend aggressive locoregional therapies for patients with DLN metastases, although future studies are still needed to confirm this finding.

What additional research needs to be done regarding breast cancer survival outcomes for patients with DLN versus ISLN metastases?

Dr. Zhou: The role of lymph node metastases in breast cancer needs to be reassessed. Randomized multicenter clinical trials and observational studies with adequate, high-quality follow-up are required in order to further evaluate survival outcomes for patients with breast cancer who have DLN versus ISLN metastases.

About Dr. Zhou

Wenbin Zhou, MD, PhD, is an Assistant Professor and attending surgeon in the Department of Breast Surgery at the First Affiliated Hospital of Nanjing Medical University in Nanjing, China. He is also affiliated with the Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment at the Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine of the Nanjing Medical University School of Public Health. Dr. Zhou specializes in the treatment of patients with breast cancer, with particular expertise in breast cancer imaging and surgical techniques. He has authored or coauthored more than 100 publications in peer-reviewed journals.

For More Information

Pan H, Wang H, Qian M, et al (2021). Comparison of survival outcomes among patients with breast cancer with distant vs ipsilateral supraclavicular lymph node metastases. JAMA Netw Open, 4(3):e211809. DOI:10.1001/jamanetworkopen.2021.1809

Transcript edited for clarity. Any views expressed above are the speaker’s own and do not necessarily reflect those of Oncology Data Advisor.

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