• metastatic breast cancer;
  • survival analysis;
  • overall survival (OS);
  • hormone treatment;
  • receptor-positive;
  • receptor-negative

This study compares the survival of breast cancer patients who are metastatic at diagnosis (DMBC) and of recurrent metastatic breast cancer (RMBC) patients. We analyzed retrospectively the population-based data of Breast Cancer Registry of Palermo and collected a total of 4459 breast cancer cases in the years 1999–2005. Survival analysis did not show statistically significant differences between DMBC and RMBC patients (P= 0.882). Endocrine manipulation is the treatment of choice in the case of hormone receptor-positive breast tumors. In 91 receptor-positive DMBC patients the endocrine treatment was associated with a prolonged overall survival (OS) (median survival 33.5 months compared to 29 months for receptor-positive patients who did not receive hormone treatment). Receptor-negative patients who underwent endocrine therapy (76% of cases) survived longer than receptor-negative patients who did not receive hormone treatment (median survival 28.5 months vs. 15 months, respectively). This evidence supports the concept that endocrine therapies impinging upon molecular targets other than hormone receptors may increase survival rates of breast cancer patients.