Yonsei Med J.  2013 Sep;54(5):1168-1177. 10.3349/ymj.2013.54.5.1168.

Prognostic Factors for Patients with Bone-Only Metastasis in Breast Cancer

• Ahn SG
• Lee HM
• Cho SH
• Lee SA
• Hwang SH
• Jeong J
• Lee HD

• KMID: 1793164
• DOI: http://doi.org/10.3349/ymj.2013.54.5.1168

Abstract

PURPOSE
Bone is the most frequent site of metastasis among breast cancer patients. We investigated prognostic factors affecting survival following bone-only metastasis in breast cancer patients.
MATERIALS AND METHODS
The medical records of breast cancer patients who were treated and followed at Gangnam Severance Hospital retrospectively reviewed to identify patients with bone-only metastasis.
RESULTS
The median time from the diagnosis of bone-only metastasis to the last follow-up or death was 55.2 [95% confidence interval (CI), 38.6-71.9] months. The Kaplan-Meier overall survival estimate at 10 years for all patients was 34.9%. In the multivariate Cox regression model, bisphosphonate treatment [hazard ratio=0.18; 95% CI, 0.07-0.43], estrogen receptor positivity (hazard ratio=0.51; 95% CI, 0.28-0.94), and solitary bone metastasis (hazard ratio=0.32; 95% CI, 0.14-0.72) were significantly associated with longer overall survival in the bone-only recurrence group. Among the treatment modalities, only bisphosphonate treatment was identified as a significant prognostic factor.
CONCLUSION
Identifying the factors influencing breast cancer mortality after bone-only metastasis will help clarify the clinical course and improve the treatment outcome for patients with breast cancer and bone-only metastasis. Bisphosphonates, as a significant prognostic factor, warrant further investigation.

Keyword

Breast neoplasm; bone metastses; bisphosphonate

MeSH Terms

Adult
Antineoplastic Agents/therapeutic use
Bone Neoplasms/drug therapy/genetics/*secondary
Breast Neoplasms/drug therapy/genetics/*pathology
Female
Humans
Middle Aged
Multivariate Analysis
Prognosis
Receptors, Estrogen/genetics
Receptors, Progesterone/genetics
Regression Analysis
Retrospective Studies
Survival Analysis
Antineoplastic Agents
Receptors, Estrogen
Receptors, Progesterone

Figure

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  Fig. 1 Kaplan-Meier plot showing OS for all patients. OS, overall survival.

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  Fig. 2 Kaplan-Meier plot showing OS stratified by (A) bisphosphonate treatment (log-rank test, p<0.001) (B) ER status (log-rank test, p=0.027) (C) the recurrence-free interval (log-rank test, p<0.001), and (D) the number of bone metastases (log-rank test, p<0.001). OS, overall survival; ER, estrogen; RFI, recurrence-free interval.

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