Background: Breast cancer is the most prevalent cancer in women in the world. Estrogen receptor modulators and estrogen deprivation have become standards of care for hormonal positive Her2 negative metastatic breast cancer patients. However, after traditional first-line endocrine monotherapy treatment, the disease typically progresses despite the initial high rate of clinical benefit. Multiple studies have aimed at optimizing treatment strategies to improve clinical benefit beyond the traditional single-agent endocrine treatment. Aim of the Work: To analyse retrospectively clinic-pathological outcome of hormonal positive Her2 negative metastatic breast cancer patients treated in clinical oncology department in Ain Shams University hospitals in Egypt during the period from January 2017 till December 2019.
Patients and Methods: This is a retrospective study which included 104 hormonal positive Her-2 negative metastatic breast cancer female patients attending the breast clinic at the Clinical Oncology Department, Ain Shams University during the period between January 2017 till December 2019.
Result: Overall, of the 104 patients in the present study, eleven patients lost follow up, forty-two patients (40.4 %) died, and fifty-one patients (49 %) are alive till the end of our follow up. The median OS is 45.47 months, while the median PFS is 10.98 months. Age had a significant impact on PFS where patients aged more than 50 years had longer PFS (13.95 months) than those patients younger than 50 years (9.3 months) (P=0.034). Patients with metastatic breast cancer from the start were associated with longer progression free survival (PFS) (13.9 months), in comparison to patients metastatic after neoadjuvant chemotherapy (6.9 months) and after adjuvant chemotherapy (9.3 months),
In the present study, regarding previous adjuvant hormonal treatment in recurrent breast cancer patients, those who received tamoxifen as prior adjuvant hormonal treatment had median OS 59.28 months and PFS 13.94 months, however, patients who did not receive tamoxifen as adjuvant hormonal treatment had median OS 37.68 months and PFS 7.86 months. Patients who received Aromatase inhibitors as prior adjuvant hormonal treatment had median PFS 13.94 months however, patients who did not receive AI as adjuvant hormonal treatment had median PFS 9.6 months. Conclusion: In general, endocrine therapy represents the mainstay for most patients with hormone receptor positive metastatic breast cancer patients. Many prognostic factors impact survival in patients with hormone receptor positive Her2 negative advanced breast cancer.