Identifying factors related to bone metastasis in breast cancer
- VernacularTitle:乳腺癌骨转移相关的临床病理因素的研究
- Author:
Jiong WU
;
Zhimin SHAO
;
Kunwei SHEN
- Publication Type:Journal Article
- Keywords:
breast neoplasms;
bone metastasis;
pathology;
multivariate logistric regression
- From:
China Oncology
1998;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Purpose: To analyze the clinical and pathological factors in post-operative breast cancer patients with bone metastasis, and, identify risk factors predicting the skeletal metastasis. Methods: We evaluated data from 3 796 patients who were surgically treated from January 1981 to December 2000. Those patients were divided into groups according to different first events. Then we assessed data of 116 cases of bone metastasis as first event, and comparing with visceral metastasis and lymph node or soft tissue metastasis cases. Results: In our group there were 116 cases with bone metastasis as first event, about 3. 1%; bone metastasis correlated with young age, large tumor, clinical palpable axillary nodes, pathological positive nodes, stage II/HI disease and non-specific invasvie breast carcinoma. Multivariate logistic regression found that large tumor, clinical palpable axillary nodes related with bone metastasis in pre-operative data. In post-operative data, large tumor, pathological positive nodes and non-specific invasive breast carcinoma correlated with bone metastasis. Hormone receptor status and HER2 expression did not predict the bone metastasis. All cases received standard local and adjuvant systemic treatment. Among patients who had as their first event a local recurrence or a recurrence in soft tissue or lymph node or local and systemic metastasis, there were more specific invasive carcinomas than those in bone metastasis group. Occurrence of bone metastasis and visceral metastasis had similar time distribution, however, local recurrence and/or node, soft tissue metastasis occurred earlier than skeletal metastasis. Conclusions: Pre-operative bone scintigraphy was indicated in those with young age, T2/T3 tumor, and clinical palpable nodes. Breast cancer patients at high risk for bone metastasis were T2/T3 tumor, non-specific invasive breast carcinoma and with 4 or more involved axillary lymph nodes. It might be important to study the effect of bisphosphonates in the adjuvant settings.
