Clinicopathological Features And Prognosis Of Breast Cancer Patients With Bone Metastasis

Objective:To investigate the clinical features and prognosis of 270 cases breast cancer patients with bone metastasis Method:Collecting 270 cases breast cancer patients with bone metastasis who were diagnosed and treated by People's Hospital Of Zhengzhou University from January 2004 to January 2014,including 65 cases of luminal A,128 cases of luminal B,46 cases of HER-2 overexpression and 31 cases of triple negative.Summarizing the clinical and pathological data,the clinicopathological features and prognosis of four different molecular types of breast cancer patients with bone metastases were analyzed retrospectively.The clinicopathological features and prognosis of breast cancer patients with bone metastasis with or without skeletal-related events were analyzed retrospectively.SPSS 22.0 software was used for data analysis.The enumeration data was expressed by percentage,the comparison between groups was conducted by chi-square test,the survival time was analyzed by kaplan-meier method,and the log-rank test was performed.K-M univariate analysis and COX proportional risk model were used to analyze univariate risk factors affecting the skeletal-related events free interval,and P<0.05 was considered statistically significant.Results:(1)There were statistical significant differences in the confirmed bone metastasis age(P = 0.016)),primary tumor size(P < 0.001)and number of lymph node metastasis(P = 0.002)of breast cancer patients with bone metastases,while in postmenopausal status(P > 0.05),histological grade(P > 0.05),different molecular classification of breast cancer patients,vascular tumor emboli presence of clinical pathology(P > 0.05),and other aspects of the differences had no statistical significance.(2)The survival time of bone metastasis in patients with different molecular types of breast cancer was statistically significant,and the survival time of bone metastasis in patients with triple-negative breast cancer was the shortest.Kaplan-meier survival analysis pairwise comparison found that there were no statistically significant differences in bone survival time of breast cancer patients with bone metastasis in Luminal A group compared with her-2 overexpression group(P=0.013),Luminal A group compared with trinegative group(P<0.001),and Luminal B group compared with trinegative group(P<0.001).There were no statistically significant differences in Luminal A versus Luminal B(P=0.210)and her-2 overexpression versus triple-negative(P=0.077),while the former survives longer than the latter.(3)Kaplan-meier univariate analysis and COX proportional risk model found that bone metastasis patients whose number of bone metastases was greater than or equal to 5,and patients with bone metastasis to other sites had shorter skeletal-related events free interval,and the difference was statistically significant(HR=1.291,P=0.026).HR=1.616,P=0.018),molecular type(P=0.756),primary tumor size(P=0.273),number of lymph node metastases(P=0.708),and history of fracture(P=0.513)were not related to the skeletal-related events free interval in breast cancer patients with bone metastasis.(4)The median bone survival time of 148 cases breast cancer patients with bone metastasis with SREs was 24 months,and the 5-year survival rate after the diagnosis of bone metastasis was 18.9%,the follow-up time was 3-116 months.The median bone survival time in 122 cases breast cancer patients of bone metastasis without SREs was 27 months,and the 5-year survival rate after the diagnosis of bone metastasis was 21.3%.The follow-up time was 6-118 months.There was no significant difference in survival time between the two groups(P=0.725).Conclusion:(1)Survival time after bone metastasis was different in patients with different molecular types of breast cancer,the three-negative type of breast cancer patients with bone metastases had the shortest survival time for bone metastases.(2)The skeletal-related events free interval was shorter in breast cancer patients with bone metastasis whose number of bone metastases was greater than or equal to 5and had other sites of metastatic lesions.(3)The median survival time and 5-year survival rate after bone metastasis in breast cancer patients without SREs were superior to those of breast cancer patients with SREs,but the difference was not statistically significant.