Cancer Management and Research (Aug 2022)

Clinical Characteristics, Prognostic Factors and Treatment Outcomes of Patients with Bone-Only Metastatic Breast Cancer

  • Marie L,
  • Braik D,
  • Abdel-Razeq N,
  • Abu-Fares H,
  • Al-Thunaibat A,
  • Abdel-Razeq H

Journal volume & issue
Vol. Volume 14
pp. 2519 – 2531

Abstract

Read online

Lina Marie,1 Dina Braik,1 Nayef Abdel-Razeq,2 Hala Abu-Fares,1 Ahmad Al-Thunaibat,1 Hikmat Abdel-Razeq1,3 1Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan; 2Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA; 3School of Medicine, the University of Jordan, Amman, JordanCorrespondence: Hikmat Abdel-Razeq, Department of Internal Medicine, King Hussein Cancer Center, Queen Rania Al Abdullah Street, P.O. Box: 1269, Amman, 11941, Jordan, Tel +962-6 5300460, Ext: 1000, Email [email protected]: Bone is the most frequent site of breast cancer metastasis. Differences between those who present with de novo bone-only metastasis (BOM) and those who progress to bone-only disease following a diagnosis of early-stage breast cancer are not clear. Such differences in clinical course might have an impact on the aggressiveness of treatment. This study presents the clinical and pathological features, along with treatment outcomes, of breast cancer patients with BOM in relation to the timing and type of bone metastasis.Patients and Methods: Patients with breast cancer and BOM were retrospectively reviewed. De novo BOM was defined as bone metastasis diagnosed at presentation or within the first 4 months of follow-up. Treatment outcomes of patients with de novo, compared to those with subsequent BOM, are presented.Results: 242 patients, median age (range) at diagnosis was 52 (27– 80) years were enrolled. The majority of the patients (77.3%) had de novo BOM with multiple sites of bone involvement (82.6%). At a median follow-up of 37.7 months, the median overall survival (OS) for patients with de novo BOM disease was significantly shorter than those who developed so subsequently; 40.8 months (95% CI, 51.1– 184.1) compared to 80.9 months (95% CI, 36.4– 47.9), p < 0.001. Tumor grade, hormone receptor status and type of bone lesions (lytic versus sclerotic) had a significant impact on survival outcomes.Conclusion: Breast cancer with de novo BOM is a distinct clinical entity with unfavorable prognosis and is associated with shorter survival. Several risk factors for poor outcomes were identified and might inform treatment plans.Keywords: breast cancer, bone metastasis, bone-only metastasis, de novo metastasis

Keywords