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Breast cancer liver metastases and the impact of receptor expression on survival
Umeå University, Faculty of Medicine, Department of Diagnostics and Intervention.
Umeå University, Faculty of Medicine, Department of Diagnostics and Intervention.
Umeå University, Faculty of Medicine, Department of Diagnostics and Intervention.ORCID iD: 0000-0003-0571-7265
Umeå University, Faculty of Medicine, Department of Diagnostics and Intervention.
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2026 (English)In: Clinical and Experimental Metastasis, ISSN 0262-0898, E-ISSN 1573-7276, Vol. 43, no 1, article id 8Article in journal (Refereed) Published
Abstract [en]

The aim was to determine the frequency of altered receptor expression between primary breast cancer and liver metastases, and to examine the impact of receptor expression on survival. The conversion frequency of estrogen- (ER), progesterone- (PgR) and human epidermal growth factor receptor 2 (HER2) was investigated. The prognostic value of the receptor status in the primary tumor versus the metastases was estimated. Data on a population-based regional cohort of 7292 breast cancer patients from 2009 to 2018 were collected from the National Breast Cancer Register. Biomarker expression and intrinsic subtype was studied among those who developed liver metastases with available histopathological records. The study included 311 patients with liver metastases. Conversion of ER, PgR and HER2 occurred in 16%, 47% and 12% of patients, respectively. The subtype converted in 26%. HER2 amplification in the primary tumor or metastases was associated with improved survival. Positive ER and PgR in breast cancer and positive ER in liver metastases were beneficial for survival. A combined primary tumor and metastasis receptor evaluation had the highest prognostic value. Receptor conversion from primary tumor to liver metastases is common. HER2 amplification and positive ER or PgR are associated with improved survival. Accordingly, luminal HER2 positive tumors have improved survival compared to other intrinsic subtypes. To personalize treatment for each patient, a liver biopsy is warranted at diagnosis of breast cancer liver metastases.

Place, publisher, year, edition, pages
Springer, 2026. Vol. 43, no 1, article id 8
Keywords [en]
Breast cancer, Breast cancer liver metastases, Estrogen (ER), Human epidermal growth factor receptor 2 (HER2), Progesterone (PgR), Receptor conversion
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-248995DOI: 10.1007/s10585-025-10387-6ISI: 001658828600001PubMedID: 41511682Scopus ID: 2-s2.0-105027120756OAI: oai:DiVA.org:umu-248995DiVA, id: diva2:2034861
Funder
Bröstcancerförbundet, 2018-0008Region Västerbotten, RV1014216Available from: 2026-02-03 Created: 2026-02-03 Last updated: 2026-04-27Bibliographically approved
In thesis
1. Breast cancer liver metastases: incidence, prognosis and surgical treatment
Open this publication in new window or tab >>Breast cancer liver metastases: incidence, prognosis and surgical treatment
2026 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Levermetastaser från bröstcancer : incidens, prognos och kirurgisk behandling
Abstract [en]

Despite great advances in the treatment of breast cancer, metastatic breast cancer is still a serious condition. The prognosis can differ significantly depending on which organs are affected. Liver metastases are associated with a poor prognosis. It is known that the properties of tumour cells change from the original tumour in the breast to the metastases, but this is incompletely described for liver metastases. Surgery of liver metastases has become a standard treatment for certain tumor diseases but is poorly studied in breast cancer. The aim of this thesis was to determine prognostic factors in breast cancer liver metastases and how tumour characteristics change from primary tumour to metastases. We also aimed to determine the incidence and timing of liver metastases. Finally the aim of the thesis was to evaluate how surgery of liver metastases affects survival and which factors control the results. All four included studies are retrospective registry studies. The results show that the properties of the tumour cells often change from primary breast cancer to liver metastases. Liver metastases are common in advanced breast cancer but isolated oligometastases (<5) are rare. Few patients have undergone surgery in Sweden due to liver metastases from breast cancer. In selected cases, surgery may be able to prolong survival.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2026. p. 63
Keywords
Breast cancer, Liver metastases, Surgery
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-252506 (URN)978-91-8070-990-3 (ISBN)978-91-8070-991-0 (ISBN)
Public defence
2026-05-22, Aulan, Sunderby Sjukhus, Luleå, Sunderby Sjukhus, Sunderbyn, Luleå, 09:00 (Swedish)
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Supervisors
Available from: 2026-04-29 Created: 2026-04-27 Last updated: 2026-04-29Bibliographically approved

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Hansson, EllenSundén, MarcusWadsten, CharlottaRask, GunillaAndersson, AnneSund, MalinHemmingsson, Oskar

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