4P - Relationship between Notttingham Grade and other histopathologic characteristics and the time to diagnosis of bone metastases from breast cancer: O...

Date 04 May 2017
Event IMPAKT 2017
Session Welcome reception and Poster Walk
Topics Breast Cancer
Staging Procedures (clinical staging)
Basic Principles in the Management and Treatment (of cancer)
Presenter Mark Wickre
Authors M. Wickre1, P. Craig1, A. Elfstrum2, S. Hui3
  • 1Radiology, University of Minnesota, 55455 - Minneapolis/US
  • 2Biology, University of Minnesota, 55455 - Minneapolis/US
  • 3Radiation Oncology, Beckman Research Institute, 91010 - City of Hope/US



Purpose: Recent developments in the treatment for early bone metastases (BM) requires better understanding of the metastatic distribution, incidence, and timing of bone metastases, as it may be possible to employ these therapies early in the course of treatment to improve outcomes from bone metastases. The purpose of this study was to identify a relationship between the Nottingham Grade and other tumor characteristics and the time to diagnosis of bone metastases based on data from a single institution.

Methods: Insitutional IRB approval was obtained. 287 patients with a diagnosis of breast cancer and bone metastases were included. Patients with a second primary cancer (n=7), lack of sufficient clinical or pathological data (n=86), inconclusive or unclear imaging correlation (n=49), and refusal of consent for retrospective chart review (n=2) were excluded. 143 breast cancer patients were ultimately included. The time to diagnosis of BM, pathological data including Nottingham Grade, receptor status, histological subtype, tumor size, and lymph node status were recorded for analysis. For those without BM at primary diagnosis, the mean interval (time to BM) are reported, and the distribution compared among factor levels by Kruskal-Wallis tests.

Results: 24% of patients with breast cancer in our study were diagnosed at initial presentation. The mean time to development of BM if not diagnosed at staging was 81 months. There was no significant difference in the time to diagnosis based on univariate analysis of Nottingham Grade (p = 0.11), receptor status (p = 0.18), histological subtype (p = 0.62), tumor size (p = 0.92), or lymph node status at diagnosis (p = 0.24).

Conclusion: While there have been many attempts to characterize the prognostic factors for metastases from breast cancer, few studies focus on the time course to development of bone metastasess to aid in clinical decision making for the earliest possible detection and diagnosis. Here we were unable to show a significant relationship between the Nottingham Grade or other histopathological factors and the time to diagnosis of bone metastases.

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