A predictive model for liver metastasis as the first distant metastasis of breast cancer

Purpose Establishing a predictive model to screen for breast cancer patients at high risk of liver metastasis enables early intervention, thereby delaying the onset of liver metastasis and enhancing both the Disease-Free Survival (DMFS) and Overall Survival (OS) of affected patients. Methods A cohort of 647 patients with pathologically confirmed breast cancer liver metastases, 588 patients with lung metastases, and 189 patients with brain metastases (verified through both pathological and imaging methods) were assembled from the Affiliated Cancer Hospital of Zhengzhou University between January 2004 and December 2023, the deadline for obtaining all data is April 5, 2024. Exclusion criteria included patients with initial distant organ metastases to the lungs or brain, those with synchronous multiple organ metastases, patients with bilateral breast cancer, and those who refused surgical intervention or had concurrent malignancies at other sites. Ultimately, a group of 417 patients with primary liver metastases was identified for the study. Results High-risk factors for breast cancer liver metastasis include hormone receptor status, molecular subtyping, lymph node involvement, KI-67 expression, local recurrence, bone metastasis, and suboptimal treatment regimens. Conclusions Hormone receptor status, molecular subtyping, lymph node involvement, KI-67 expression, local recurrence, bone metastases, and inadequate treatment emerged as significant risk factors for liver metastasis as the first distant metastasis (non-bone metastasis) in breast cancer patients. In the management of early breast cancer, tailored intensive treatment based on these risk factors may confer survival benefits to patients.