Hard hitting (NC)DB.

Top Line: What is the rate of distant metastases in women presenting with locoregional breast cancer recurrence?
The Study: We sure wish the NC-DB could hit as hard as an Eagles DB. Well, this special study of the Commission on Cancer does. While the NCDB usually collects information regarding initial treatment, this unique study collected recurrence data on over 11K women with breast cancer from over 1K institutions. It’s a pretty data-dense paper loaded with real-world recurrence stats, so we’re gonna focus on the highlights. Among women with stage II (70%) and stage III (30%) breast cancer, 4% developed a first recurrence at a locoregional (LR) site by 5 years while another 12% developed first recurrence at a distant site. Among those with LR first recurrence, 27% discovered synchronous mets on systemic staging--which was especially common for those with nodal recurrences and higher initial stages.
Bottom Line: Among the relatively few women with breast cancer who first fail locally, over a quarter have synchronous distant metastasis. This supports not only Bernie Fisher but more importantly routine systemic imaging at the time of recurrence.

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