NEW YORK (Reuters Health) – The median survival of patients with peritoneal breast cancer metastasis is “surprisingly poor,” with only a small minority surviving longer than 6 months, new research indicates.

“Such patients with advanced disease often require frequent admission for drainage of recurrent ascites,” Dr. Justin Stebbing, from Imperial College Healthcare NHS Trust in London and co-authors report.

Information on management and prognosis of these women has been “scarce,” the researchers say, but on the basis of their findings they suggest that breast cancer with peritoneal metastases “represents a specific entity, with a very poor outcome.”

As reported in the August issue of the European Journal of Cancer, the investigators reviewed outcomes of 44 women with confirmed peritoneal disease from breast cancer. In 34 women who had presented with early breast cancer, the median age at diagnosis was 50 years, and median age at diagnosis with peritoneal disease was 55 years. Ten women presented with stage IV breast cancer, with peritoneal disease already present in three.

Histology indicated 77% had invasive ductal carcinoma and 16% had invasive lobular carcinoma; for 7% the tumor type could not be determined.

Patients had a median of 3 chemotherapy treatments and 2 hormonal treatments prior to diagnosis of peritoneal disease. After diagnosis, 25 were treated with further chemotherapy, and 8 received second or third line hormonal treatments. Thirty-eight required paracentesis at least once.

Median survival once peritoneal disease was diagnosed was 1.56 months, the authors report. Hormone-receptor-positive disease had similarly poor survival.

The researchers believe that ultimately, identification of the molecular pathways that prevent the dissemination of breast cancer cells to the peritoneum will be required for the development of effective treatment.

In the meantime, the British team concludes, “The dismal outcome of these individuals, despite further active therapy, merits their inclusion into clinical trials designed specifically for this group of patients.”

Reference:
Eur J Cancer 2009;45:2146-2149.