An open cohort study of bone metastasis incidence following surgery in breast cancer patients

BMC Cancer

Research Article

Takuji Iwase¹  Fujio Kasumi²  Masataka Yoshimoto³  Mitsuru Koizumi⁴ 

[1] Department of Breast Surgery, Cancer Institute Hospital, 3-8-31, Ariake, 135-8550, Koto-ku, Tokyo, Japan;Department of Breast Surgery, Cancer Institute Hospital, 3-8-31, Ariake, 135-8550, Koto-ku, Tokyo, Japan;Breast Center, Juntendo University, 3-1-3 Hongo, 113-8431, Bunkyo-ku, Tokyo, Japan;Department of Breast Surgery, Cancer Institute Hospital, 3-8-31, Ariake, 135-8550, Koto-ku, Tokyo, Japan;Breast Center, Mita Hospital, International University of Health and Welfare, 1-4-3 Mita, 108-8329, Minato-ku, Tokyo, Japan;Diagnostic Imaging Group, Molecular Imaging Center, National Institutes of Radiological Sciences, 4-9-1 Anagawa, 263-8555, Inage-ku, Chiba, Japan;Department of Nuclear Medicine, Cancer Institute Hospital, 3-8-31, Ariake, 135-8550, Koto-ku, Tokyo, Japan;

关键词: Breast Cancer Patient;    Bone Metastasis;    Zoledronic Acid;    Temporal Incidence;    pTNM Classification;   

DOI  :  10.1186/1471-2407-10-381

 received in 2009-09-18, accepted in 2010-07-21,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundTo help design clinical trials of adjuvant bisphosphonate therapy for breast cancer, the temporal incidence of bone metastasis was investigated in a cohort of patients. We have tried to draw the criteria to use adjuvant bisphosphonate.MethodsConsecutive breast cancer patients undergoing surgery between 1988 and 1998 (5459 patients) were followed up regarding bone metastasis until December 2006. Patients' characteristics at the time of surgery were analyzed by Cox's method, with bone metastasis as events. Patient groups were assigned according to Cox's analysis, and were judged either to require the adjuvant bisphosphonate or not, using the tentative criteria: high risk (>3% person-year), medium risk (1-3%), and low risk (<1%).ResultsBone metastasis incidence was constant between 1.0 and 2.8% per person-year more than 10 years. Non-invasive cancer was associated with a very low incidence of bone metastasis (1/436). Multivariate Cox's analysis indicated important factors for bone metastasis were tumor grade (T), nodal grade (pN), and histology. Because T and pN were important factors for bone metastasis prediction, subgroups were made by pTNM stage. Patients at stages IIIA, IIIB and IV had an incidence of >3% per person-year, patients with stage I <1% per person-year, and those with stages II were between 1 and 3%. Further analysis with histology in stage II patients showed that stage IIB with high risk histology also had a high incidence (3% person year), whereas stage IIA with medium risk histology were <1%.ConclusionsBone metastasis incidence remained constant for many years. Using pN, T, and histopathology, patients could be classified into high, medium, and low risk groups.

【 授权许可】

CC BY   
© Koizumi et al; licensee BioMed Central Ltd. 2010