Risk of metastasis among rib abnormalities on bone scans in breast cancer patients

Abstract

Bone scan abnormalities, especially rib lesions, are often confusing for physicians due to a high number of false-positive lesions. This study investigated risk factors that are associated with bone metastasis in 613 breast cancer patients with bone scan abnormalities. Significantly increased rates of bone metastasis were observed in patients with multiple lesions, large tumor sizes, and lymph node involvement. In addition, patients with concurrent lesions of rib and other sites exhibited a significant higher rate of metastatic disease compared to those with other site lesions (P = 0.009). In the subset of 324 patients with rib abnormalities, the rate of metastasis was extremely low in patients with pure rib lesions (1.2%; 95% CI: 0.1%–4.1%). Concurrent lesions of rib and other sites were more likely to be rib metastasis compared to pure rib lesions (P < 0.001). Moreover, multiple rib lesions and lesions located on bilateral ribs were more likely to be rib metastasis (P < 0.001). Our data suggest that patients with pure rib abnormalities could be recommended for follow-up only. However, if concurrent lesions of rib and other sites were detected on bone scans, additional radiological examinations should be performed to patients.

Significance of Tumor Marker CA15-3 in Metastatic Breast Cancer

“…None of stage t1nxm0, t2n2m0, t2n3mx, t3n2m0, t3n2mx related case was found. Among bone scan negative cases maximum cases of stage t2n0m0 (14) and then stages t2n0m0, t1n1m0 (9, 8) were found. No case of stage t4n1m1 was found [ .…”

“…Bone fractures can be detected by bone scan within 24 hours, except osteopenia in older patients [12]. About 75% symptomatic malignant cases easily detected by bone scintigraphy but 25%-45% of asymptomatic patients with malignancy also have positive bone scan for metastases [13,14,15]. Result of a study showed that breast cancer with multiple bone metastases is associated with advanced staging.…”

Factors associated with bone metastasis in breast cancer: a systematic review and meta-analysis

“…Eighteen studies (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) Gong et al in 2018 (14) was intended to maximize the data and prevent the inclusion of duplicate data in the meta-analysis. Eleven retrospective studies and 6 crosssectional studies were included.…”

“…Five studies (11,12,18,21,22) analyzed the effect of HR status on BM of BC. The results showed that the risk of BM was higher in HR-positive than in HR-negative BC patients (I 2 =87.7%, OR =1.39, 95% CI: 0.90, 2.16, P=0.142) (Figure 4).…”

“…Ten studies (8,9,11,12,15,16,18,19,22,24) evaluated the risk of HER2 on BM from BC. The results showed that HER2-positive BC patients had a relatively higher risk of BM (I 2 =77.6%, OR =1.35, 95% CI: 1.04, 1.76, P=0.025) (Figure 5).…”