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. 2018 Jan 25:4:2.
doi: 10.1038/s41523-018-0054-x. eCollection 2018.

Characterization of bone only metastasis patients with respect to tumor subtypes

Amanda Parkes  1 , Katherine Clifton  1 , Aydah Al-Awadhi  1 , Oluchi Oke  1 , Carla L Warneke  2 , Jennifer K Litton  3 , Gabriel N Hortobagyi  3
Affiliations

Characterization of bone only metastasis patients with respect to tumor subtypes

Amanda Parkes et al. NPJ Breast Cancer. .

Abstract

Metastatic breast cancer (MBC) patients with bone only metastasis (BOM) are a unique population with limited characterization. We identified patients followed at MD Anderson Cancer Center from 01/01/1997 to 12/31/2015 for at least 6 months with a BOM diagnosis as first site of metastasis. Tumor subtype (TS) was assessed by initial breast biopsy immunohistochemistry using hormonal receptor (HR) and HER2 status, with four subtypes identified: HR+/HER2-, HR+/HER2+, HR-/HER2-, HR-/HER2+. HR+ was defined as estrogen receptor or progesterone receptor ≥1%. We identified 1445 patients with BOM, 1048 with TS data available. Among these patients, the majority were HR+/HER2- (78%). Median time from breast cancer diagnosis to first bone metastasis was 2.3 years (95% CI 2.1, 2.5) and varied significantly by TS, with longer time to distant disease in HR+/HER2- patients relative to all other TS (p < .0001). Median overall survival (OS) from breast cancer diagnosis was 8.7 years (95% CI 8.0, 9.7) and varied significantly by TS with poorer OS for HR-/HER2- and HR-/HER2+ patients relative to HR+/HER2- TS (p < .0001). The 442 patients with de novo BOM disease, defined as bone metastasis diagnosis within 4 months of breast cancer diagnosis, had significantly shorter OS (p < .0001). Overall, several higher risk BOM subsets were identified in this analysis, most notably HR-/HER2+ and HR-/HER2- TS and de novo BOM patients.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Fig. 1
Fig. 1
Time from breast cancer diagnosis to BOM diagnosis in years stratified by TS with pair-wise comparisons utilized to compare TS
Fig. 2
Fig. 2
a OS from breast cancer diagnosis (top) and b OS from distant disease diagnosis (bottom), both stratified by TS
Fig. 3
Fig. 3
OS from breast cancer diagnosis in 442 patients with de novo BOM disease, defined as diagnosis of bone metastasis at the same time or within 4 months after breast cancer diagnosis
See this image and copyright information in PMC

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