Bone Metastasis Prognostic Factors in Breast Cancer

Abstract

Objective: Bone is the most common site of metastasis in breast cancer. Prognostic factors for predicting bone metastases in breast cancer are controversial yet. In this study, we investigated clinical factors associated with secondary bone metastasis of breast cancer. Methods: In total, 1690 patients with breast cancer recorded between 2002 and 2012 in Motamed Cancer Institute, Tehran, Iran entered in the retrospective study. We studied age, menopausal status, histologic type, tumor size, number of cancerous axillary lymph nodes, serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA)-153, and hemoglobin (HB) in 2 groups with bone metastases (n = 123) and without it, respectively. We applied logistic regression to identify bone metastasis prognostic factors in breast cancer patients and calculated the cut-off value, sensitivity, and characteristics of independent prognostic factors using receiver operating characteristic (ROC) curve analysis. Results: Menopause, larger tumor size, and the greater number of cancerous axillary lymph nodes increased the chance of bone metastases significantly ( P < .05). There was no significant difference between mean groups with and without bone metastases regarding serum concentration of CEA, CA-153, HB, and histopathologic type ( P > .05). Logistic regression showed that age (odds ratio (OR) = 1.021), menopausal status (OR = 1.854), number of cancerous axillary lymph nodes (OR = 1.065), a tumor size between 2 and 5 cm diameter (OR = 2.002) and more than 5 cm diameter (OR = 4.009), and ALP (OR = 1.005) are independent prognostic factors associated with bone metastases. The ROC curve showed that the abovementioned factors have comparable predictive accuracy for bone metastases. Conclusions: Age, menopausal status, number of axillary lymph node metastases, tumor size, and ALP were identified as prognostic factors for bone metastasis in patients with breast cancer. So patients with these characteristics should be monitored more precisely with regular follow-ups.

Investigation of Prognostic Factors of Survival in Breast Cancer Using a Frailty Model: A Multicenter Study

“…5,6 Various studies have been performed in Iran to determine the factors affecting the survival in breast cancer patients and estimate the survival time. 7-10 However, the factors identified in each study have been different from other studies and the extent of the effects of some of these factors has also been controversial. For example, the effects of the type of surgery (modified radical mastectomy [MRM] and breast conservation surgery [BCS]), chemotherapy, and radiotherapy on the survival of patients are the most discussed issues in recent years.…”

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“…The number of axillary nodes of metastases and tumor size appear an important prognostic factors for LMs in BC. The generalizability of these results is subject to several limitations [13][14][15][16][17][18][19][20].…”

Diagnostic value of radionuclide in bone metastasis after breast cancer surgery

“…[ 3 , 4 ] It is reported that about 90% to 95% patients are diagnosed at early stage and 20% to 30% of them have metastatic. [ 5 ] Bone metastatic (BM) is the most frequent metastases in patients with BC, [ 6 , 7 ] with >75% of stage IV BC develop to BM, which is incurable for these patients. [ 8 , 9 ] Thus, it is very to treat BC at early stage.…”