Identification of Breast Cancer Patients at Risk for Bone Metastasis – A Case–Control Study

Case Report | Volume 5 | Issue 2 | JBST May – August 2019 | Page 15-19| Purnima Thakur, Vishal Verma, Ekta Dogra, Ankur Gupta, Manish Gupta, Vikas Fotedar. DOI: 10.13107/jbst.2019.v05i02.430

Author Purnima Thakur[1], Vishal Verma[2], Ekta Dogra[3], Ankur Gupta[4], Manish Gupta[1], Vikas Fotedar[1]
[1]Department of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India,
[2]Department of Orthopedics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India,
[3]Department of Community Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
[4]Department of Anatomy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.

Address of Correspondence
Dr. Vishal Verma,
Department of Orthopedics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
E-mail: vishhal82@gmail.com

Abstract
Introduction: Prognostic factors for metastatic breast carcinoma are a less studied topic than a prognostic factor for primary breast cancer. Bone is the most frequent site for metastasis in breast cancer patients. Bone metastasis decreases the survival and impacts the quality of life(QoL)in breast cancer patients. Therefore, the study to identify prognostic factors of this specific group of patients appears to be worthy of more detailed study. To the best of our knowledge, this is the first study of its kind in the North Indian population.
Materials and Methods: A retrospective case–control study was conducted at a tertiary cancer centerin Northern India between January 2011 and December 2015. All patients’ clinical and demographic data were obtained from the medical record of the institute. The incidence and distribution of bone metastases from breast cancer were evaluated, and the correlation between diverse clinical-pathological parameters and bone metastases were analyzed in this study.
Results: A total of 363 patients were recruited, including 94 cases with bone metastases and 269 controls without bone metastases at presentation. Positive axillary lymph node status, higher stage tumors, HER2 neu-negative disease, and histological subtypes of tumor were found significant prognostic factors in univariate analysis associated with higher rates of bone metastasis. Luminal A(estrogen receptor-positive [ER+], progesterone receptor-positive [PR+], HER2–ve, Grade 1,2), and HER 2 enriched (ER –ve, PR–ve, and HER 2+) molecular subtypes are associated with increased risk of bone metastasis. None of the risk factors studied were significantly associated with bonemetastasis in binary logistic regression analysis.
Conclusion: Identification of breast cancer patients at risk for bone metastasis may aid in the prevention, prediction, detection, and early treatment of these lesions, thus providing improved survival and better QoL.
Keywords: Bone metastasis, risk factors, breast cancer.

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Dr. Purnima Thakur Dr. Vishal Verma Dr. Ekta Dogra Dr. Ankur Gupta Dr. Manish Gupta Dr. Vikas Fotedar

 

How to Cite this article: Thakur P, Verma V, Dogra E, Gupta A, Gupta M, Fotedar V. Identification of Breast Cancer Patients at Risk for Bone Metastasis – A Case–Control Study. Journal of Bone and Soft Tissue Tumors May-August 2019;5(2): 15-19.

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