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However, we also observed polyclonal seeding in 3 patients patients 5, 18, and 20 with a luminal subtype, while 8 of 11 patients with polyclonal seeding had nonluminal subtypes 6 basal and 2 HER2 enriched. A Mutational signatures S1—S4. Probability of linear progression from an earlier metastasis to a subsequent metastasis.

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Thus, sequencing studies within larger patient cohorts as well as ultra-deep sequencing will help to confirm our results regarding progression patterns and the passive role of ALN metastasis in seeding distant organ metastases. A recent study by Brastianos et al. Five metastatic samples failed in the exome sequencing that yielded ninety-nine samples in total.

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July 7, ; Accepted: A Horizon plot showing smoothed frequencies of copy number alterations across the genome, with amplifications and deletions above and below the horizontal axis, respectively. Mammography is typically suboptimal for complete ALN evaluation.

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Interestingly, the colon metastasis acquired a likely deleterious BRCA2 mutation p. The subclonal analysis results also reflected the parallel progression results, in which, for instance, the red subclone consisting of 79 mutations including mutations in putative driver genes like BRCA2 , DDR2 , and ROS1 was shared exclusively between Primary5 and uterus Figure 4 and the density plot in Supplemental Figure 6D. Version 3 April 2,

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Breast cancer spreads in either a linear or parallel manner. A schematic of the timeline of relapses and relapse tumor characteristics are provided in Supplemental Figure 2 and Supplemental Table 4 , respectively. This study aims to develop a new set of nomograms to accurately predict ALN status.