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. 2022 Aug 23:14:2519-2531.
doi: 10.2147/CMAR.S369910. eCollection 2022.

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

Lina Marie  1 , Dina Braik  1 , Nayef Abdel-Razeq  2 , Hala Abu-Fares  1 , Ahmad Al-Thunaibat  1 , Hikmat Abdel-Razeq  1   3
Affiliations

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

Lina Marie et al. Cancer Manag Res. .

Abstract

Introduction: 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: bone metastasis; bone-only metastasis; breast cancer; de novo metastasis.

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Conflict of interest statement

The authors report no conflicts of interest in this work

Figures

Figure 1
Figure 1
Overall survival (A) and progression-free survival (B) for both groups; de novo bone-only metastasis (BOM) and subsequent metastasis.
Figure 2
Figure 2
Overall survival (A) and progression-free survival (B) according to tumor grade.
Figure 3
Figure 3
Survival according to type of bone metastasis: (A) overall survival, (B) progression-free survival.
Figure 4
Figure 4
Survival according to hormonal receptor (HR) and HER2 status: (A) overall survival, (B) progression-free survival.
See this image and copyright information in PMC

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