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Clin Breast Cancer. 2015 Feb;15(1):37-42. doi: 10.1016/j.clbc.2014.06.007. Epub 2014 Aug 15.

Clinical characteristics and outcome of bone-only metastasis in inflammatory and noninflammatory breast cancers.

Author information

1
Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX.
2
Department of Biostatistics, The University Texas MD Anderson Cancer Center, Houston, TX.
3
Departments of Breast and Endocrine Surgery Tokai University School of Medicine, Kanagawa, Japan.
4
Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX. Electronic address: nueno@mdanderson.org.

Abstract

BACKGROUND:

Inflammatory breast cancer is a rare and aggressive presentation of breast cancer. Bone is a common metastatic site in breast cancer, and bone-only metastatic disease is clinically considered to have a better prognosis than visceral metastasis. However, bone-only metastasis in IBC (bone-only IBC) has not been compared with bone-only metastasis in non-IBC (bone-only non-IBC) in terms of clinical features and outcome. Because of the intrinsically aggressive nature of IBC, we hypothesized that bone-only IBC has a poorer prognosis than does bone-only non-IBC.

PATIENTS AND METHODS:

We retrospectively identified patients with stage III primary diagnosed breast cancer who, between January 1997 and December 2012, had a first recurrence located only in the bone. Among the 197 patients that we defined as a study cohort, 50 patients had IBC and 147 patients had non-IBC. Progression-free survival (PFS) and overall survival (OS) from the date of recurrence were estimated using the Kaplan-Meier method, and patient characteristic groups were compared using the log-rank test.

RESULTS:

OS did not differ significantly between the 2 groups (P = .2467), but a shorter PFS was seen in patients with bone-only IBC than in patients with bone-only non-IBC (P = .0357). Among patients with estrogen receptor (ER)-positive disease, a much shorter PFS was seen in bone-only IBC than in bone-only non-IBC (P = .0159).

CONCLUSION:

Bone-only IBC has a poorer prognosis than does bone-only non-IBC, particularly in those with ER-positive tumors. We might need to consider more aggressive intervention (e.g., chemotherapy) for IBC patients with ER-positive bone-only metastatic disease.

KEYWORDS:

Advanced breast cancer; Bone metastasis; Hormone receptor positivity; Overall survival; Progression-free survival

PMID:
25258308
DOI:
10.1016/j.clbc.2014.06.007
[Indexed for MEDLINE]

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