Incidence proportions and prognosis of breast cancer patients with bone metastases at initial diagnosis

Gong, Yue; Zhang, Jing; Ji, Peng; Ling, Hong; Hu, Xin; Shao, Zhi‐Ming

doi:10.1002/cam4.1668

Cited by 41 publications

(52 citation statements)

References 40 publications

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“…HR+/HER2-breast cancer were historically considered to have a relatively favorable prognosis, whereas HR+/HER2+ subtype seemed to have the best prognosis and HR+/HER2-and HR-/HER2+ subtype had similar survival among patients with de novo metastatic breast cancer in the HER2-targeted therapy era [49,50]. Among breast cancer patients with de novo brain or bone metastases, results were consistent with those in de novo metastatic breast cancer patients [51,52], while HR-/HER2+ subtype had a worse prognosis than the HR+/HER2-subtype among breast cancer patients with de novo lung metastases [53]. Differently, HR-/HER2+ BCLM patients may have a better prognosis than the HR+/HER2-subtype in our study.…”

Section: Discussionsupporting

confidence: 56%

Risk and prognostic factors of breast cancer with liver metastases

Liu

Zhu

et al. 2020

Preprint

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Background: Liver metastasis is a significant adverse predictor of overall survival (OS) among breast cancer patients. The purpose of this study was to determine the risk and prognostic factors of breast cancer with liver metastases (BCLM). Methods: Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were included. Logistic regression was used to identify risk factors for liver metastasis. Cox proportional hazards regression model was adopted to determine independent prognostic factors in BCLM patients.Results: Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+) were risk factors for developing liver metastasis. The median OS after liver metastasis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. Molecular subtypes also played a critical role in the survival of BCLM patients. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS (38.0 for SEER vs. 34.0months for FUSCC), whereas triple-negative breast cancer had the shortest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR)=2.62; 95% confidence interval (CI)= 1.88-3.66; P<0.001) and HR-/HER2+ (HR=3.43; 95% CI=2.28-5.15; P<0.001) were associated with a significantly increased death risk in comparison with HR+/HER2- patients if these patients did not receive HER2-targeted therapy. For those who underwent HER2-targeted therapy, however, HR+/HER2+ subtype reduced death risk compared with HR+/HER2- subtype (HR=0.74; 95% CI=0.58-0.95; P<0.001).Conclusions: Breast cancer patients at a high risk for developing liver metastasis deserve more attention during the follow-up. BCLM patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative patients due to the introduction of HER2-targeted therapy and therefore it should be recommended for HER2+ BCLM patients.

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Section: Discussionsupporting

confidence: 56%

Risk and prognostic factors of breast cancer with liver metastases

Liu

Zhu

et al. 2020

Preprint

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“…Chen et al reported that in axillary lymph node metastasis, CA125, CA153, ALP, and hemoglobin concentration were independent risk factors for BM in BC patients [ 22 ]. Yue Gong et al determined that age, ethnicity, histology, grade, tumor subtype, extra bone metastasis site, and education level were predictors of BM in BC patients [ 23 ]. Other studies have also reported that involvement of more than four axillary lymph nodes at initial diagnosis, primary tumor size greater than 2 cm, estrogen receptor positive and progesterone receptor negative tumors and younger age are risk factors for BM in BC patients [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…We speculate that patients with only BM develop vital organ dysfunction later, so these patients have a higher survival rate than those with both bone and extraosseous metastases. According to previous research, the breast cancer subtype is an independent risk factor for the occurrence of metastasis, and the incidence of BM is highest in BC patients that are HR+/HER2− or HR+/HER2+ [ 23 , 32 ]. Our results show that patients with HR+/HER2- BC have a higher risk of BM, and patients with Grade 2 BC are more likely to have BM compared to patients with Grades 3 and 4 BC, which is controversial.…”

Section: Discussionmentioning

confidence: 99%

Risk factors, prognostic factors, and nomograms for bone metastasis in patients with newly diagnosed infiltrating duct carcinoma of the breast: a population-based study

Huang

Liu

et al. 2020

BMC Cancer

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Background Breast cancer is the most common malignancy in women, and it is also the leading cause of death in female patients; the most common pathological type of BC is infiltrating duct carcinoma (IDC). Some nomograms have been developed to predict bone metastasis (BM) in patients with breast cancer. However, there are no studies on diagnostic and prognostic nomograms for BM in newly diagnosed IDC patients. Methods IDC patients with newly diagnosed BM from 2010 to 2016 in the Surveillance, Epidemiology and End Results (SEER) database were reviewed. Multivariate logistic regression analysis was used to identify risk factors for BM in patients with IDC. Univariate and multivariate Cox proportional hazards regression analysis were used to explore the prognostic factors of BM in patients with IDC. We then constructed nomograms to predict the risk and prognosis of BM for patients with IDC. The results were validated using bootstrap resampling and retrospective research on 113 IDC patients with BM from 2015 to 2018 at the Affiliated Hospital of Chengde Medical University. Results This study included 141,959 patients diagnosed with IDC in the SEER database, of whom 2383 cases were IDC patients with BM. The risk factors for BM in patients with IDC included sex, primary site, grade, T stage, N stage, liver metastasis, race, brain metastasis, breast cancer subtype, lung metastasis, insurance status, and marital status. The independent prognostic factors were brain metastases, race, grade, surgery, chemotherapy, age, liver metastases, breast cancer subtype, insurance status, and marital status. Through calibration, receiver operating characteristic curve and decision curve analyses, we found that the nomogram for predicting the prognosis of IDC patients with BM displayed great performance both internally and externally. Conclusion These nomograms are expected to be a precise and personalized tool for predicting the risk and prognosis for BM in patients with IDC. This will help clinicians develop more rational and effective treatment strategies.

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“…The incidence of bone metastases in lung cancer reported by Gustavo et al and Katrin et al depended on the histological subtype [22,23]. For breast cancer, it has been demonstrated that patient age, hormone receptor status, human epidermal growth factor receptor 2 and tumor size contribute to bone metastases [28,29]. Ruatta et al reviewed and analyzed renal cancer patients in their clinics and found that approximately 4% of patients had bone metastases at the time of initial diagnosis, while approximately 13% of patients had metastases during follow-up [30].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Prognosis of Bone Metastases in Common Solid Cancers at Initial Diagnosis: A Population-Based Study

Zhang

Hong

et al. 2020

Preprint

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Background Bone is one of the most common sites of advanced tumors. However, there is currently a lack of population-based surveys for the incidence and prognosis of bone metastases in common solid cancers.Methods Patients with 12 types of primary cancer and bone metastases at initial diagnosis between 2010 and 2015 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan-Meier method and Cox logistic regression were conducted to analyze survival and the effect of bone metastases on different cancers.Results We included 89,782 patients with bone metastases at cancer diagnosis. Lung cancer had the highest incidence (17.61%) of bone metastases at diagnosis in any stage, followed by liver cancer (6.29%), nasopharyngeal carcinoma (6.22%) and renal cancer (5.19%). Among patients with breast and prostate cancer, only 3.4% and 4.39%, respectively, were identified as having bone metastases at diagnosis. Breast cancer (32.1%), prostate cancer (25.2%), thyroid cancer (46.8%) and nasopharyngeal carcinoma (24.8%) patients with only bone metastasis have an over 20% five-year survival rate. Compared with patients at a stage previous to metastasis, bone metastasis significantly increased the risk of mortality and reduced survival time, especially for patients with prostate cancer (HR: 19.64, 95% CI 18.36 to 21.02). Concomitant other organ metastases make patient survival worse. Regarding the metastases of prostate cancer, bone metastases are the main type, while for colorectal cancer, bone metastases and concomitant visceral metastases mainly occur.Conclusions The findings of this study provide estimates of the incidence and prognosis of patients with bone metastases during the initial diagnosis of common solid cancers. In addition, we also clarified the degree to which bone metastasis affects patient survival. Patient prognosis depends on the primary type of cancer. These results can be used as a reference for the screening of metastases, and the optimization of personalized treatment options to improve the quality of life and survival of patients.

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Incidence proportions and prognosis of breast cancer patients with bone metastases at initial diagnosis

Cited by 41 publications

References 40 publications

Risk and prognostic factors of breast cancer with liver metastases

Risk and prognostic factors of breast cancer with liver metastases

Risk factors, prognostic factors, and nomograms for bone metastasis in patients with newly diagnosed infiltrating duct carcinoma of the breast: a population-based study

Incidence and Prognosis of Bone Metastases in Common Solid Cancers at Initial Diagnosis: A Population-Based Study

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