الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Despite advances in screening and early diagnosis, still up to 10% of breast cancer patients present with metastatic disease at the initial diagnosis. With a median survival of about 24 months, metastatic breast cancer has traditionally been considered incurable and treatment is given in a palliative intent.
Clearly, patients with MBC consist of a heterogeneous group of patients whose prognoses and clinical courses can vary depending on multiple patient related and tumor related factors. That’s why the treatment of metastatic breast cancer is becoming more complex, with few proven standards of care. However, with the recognition of intrinsic molecular and genomic subtypes of breast cancer, the treatment approach of MBC will probably change, moving from the era of empirically based treatment to the era of tailored therapies for each individual patient.
The present work was carried out retrospectively to review the demographic and clinicopathologic features of primary metastatic breast cancer patients and to identify the outcome of the different treatment lines delivered and the factors affecting survival in this population.
To achieve this aim, the present study included 302 patients with stage IV breast cancer at time of diagnosis. Those patients presented to the Department of Clinical Oncology and Nuclear Medicine of Alexandria Main University Hospital during the period from January 2003 to December 2012.
All medical records were reviewed and data about history, physical examination, clinicopathological findings, investigations, and details of treatment received (systemic and local) were retrieved and tabulated. Treatment outcomes in terms of tumor response, progression free survival and overall survival were estimated for 199 patients who have completed their full treatment course. The following variables were correlated to survival on univariate analysis: age, menopausal status, hormonal receptor status, number of metastatic sites, initial metastatic site, initial systemic treatment, total number of lines of systemic treatment and locoregional treatment.