Relationship Between ^99mTc-MDP Whole Body Bone Imaging After Breast Cancer Surgery And The Clinical Risk Factors Of Bone Metastasis

[Objective]Breast cancer is a common malignant tumor in China,which was ranked first incidence rate in the incidence of cancer in urban women.In the recent years,the incidence of breast cancer has shown a significant upward trend.So the prevention and treatment of breast cancer are becoming increasingly serious.Bone was the most common distant metastasis site in breast cancer.The occurrence of bone metastasis may cause a series of bone-related events,which seriously affected the quality and even led to death.Therefore,early diagnosis of bone metastasis and early prevention and treatment were of great significance for improving the prognosis of breast cancer patients and prolonging their survival.99mTc-MDP whole body bone imaging was currently the most commonly used method for early screening of bone metastases.This study was to investigate the relationship between the 99mTc-MDP whole body bone imaging after surgery and the risk factors of bone metastasis.[Methods]Bone imaging data of 210 postoperative patients with breast cancer were retrospectively analyzed based on clinical stages.Meanwhile,the levels of serum carcinoembryonic antigen(CEA),glycoprotein antigen 125(CA125)and glycoprotein antigen 15-3(CA15-3)were measured in one week before and after bone imaging.The axillary lymph nodes metastasis,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER-2)were all collected from the medical history data.The time interval between postoperative and bone scan was calculated.COX regression analysis was performed using SPSS 19.0 software to calculate the HR value of each index and analyze the relationship between each index and bone imaging results.[Results]In all the 210 patients of breast cancer,133(63.3%)had normal bone scans(negative)and 77(36.7%)had bone metastases(positive).COX univariate analysis showed that the risk of bone metastasis in breast cancer was higher in patients with advanced stage(?-?)than that with the early stage(?-?)(HR=1.590,P=0.050).Patients with axillary lymph node metastasis had a higher risk of bone metastases than those without(HR=1.985,P=0.006).When the level of CA125 was abnormal,the risk of bone metastasis was increased(HR=1.697,P=0.036),while the CEA and CA153 did not have the relation(HR=0.070,0.148,P>0.05);Moreover,the risk of bone metastasis after operation was not significantly correlated with the surgical type(radical/preservation)and the negative expression rate of ER,PR and HER-2(HR=0.812,0.930,0.621,0.386,P>0.05)).COX multivariate analysis showed that age,gender,TNM stage and serum CEA level were the important factors influencing the time interval between breast cancer operation and bone metastasis(HR=0.973,4.599,1.681,2.092,P?0.05).[Conclusion]Advanced TNM staging,axillary lymph node metastasis and increasing level of CA125 level were the independent risk factors for bone metastases in patients with breast cancer.Through comprehensive analysis of clinical indicators,it was considered that young and middle-aged women with increased CEA in breast cancer after operation had higher risk of bone metastasis.In such cases,whole body bone imaging was necessary to exclude the possibility of bone metastasis.