Demographic, clinical, and histopathological factors associated with increased risk of de novo metastatic disease in patients with breast cancer

Resumo

Objective: To describe the sociodemographic, clinical, and histopathological characteristics, as well as the diagnostic timeline and management initiation for patients with de novo metastatic breast cancer at a specialized oncology center. Methods: A retrospective observational study was conducted using a historical cohort that included patients diagnosed with breast cancer and initially staged between I-IIIC, who were later reclassified as stage IV based on extension studies. Results: The study included 270 patients; 77% of them took more than 60 days from the onset of symptoms to the date of the positive biopsy report for cancer, and 35.2% took more than 60 days from biopsy results to their first consultation at the specialized oncology center. Most were initially diagnosed as stage IIIB (59.3%; n=160), with the predominant molecular subtype being Luminal B HER2-negative in 41.4% of cases (n=112). Conclusions: Delay in diagnosis and referral to an oncologic entity are factors associated with the presentation of de novo stage IV breast cancer. Patients with T4 tumors, N2 involvement, and Luminal B HER2-negative subtype with histological grades 2 and 3 need more rigorous studies due to their higher risk of distant metastasis.