More than 50% of metastatic breast cancer patients experience bone metastases over the course of disease and around 15% of cases have metastases confined to the skeleton at metastatic presentation. The aim of this study was to access the overall survival of breast cancer patients with bone-only metastases at presentation.
Among 907 patients, we identified from our prospective computerized database 123 patients with bone-only metastases at diagnosis of metastatic breast cancer. We retrospectively collected data from the patients’ files.
The median overall survival was 8,3 years (CI 95% 6,7-10,3) and 73% and 41% of patients were alive at 5 and 10 years, respectively. No multivariate model with factors identified at presentation was able to predict overall survival length. Sixty per cent of patients developed visceral metastases over the time and the median interval between the diagnosis of bone metastases and the occurrence of visceral metastases was 28 months (4 - 193). In multivariate analysis, negative progesterone receptor status was associated with the occurrence of visceral metastasis (HR = 2,4; p = 0,03). Eleven per cent of patients had a solitary bone metastasis; 67% of patients developed axial metastases and 41% long bone metastases.
Breast cancer patients with bone-only metastases at presentation of metastatic disease might form a distinct clinical entity among metastatic breast cancer patients with a favorable prognosis and a prolonged overall survival. No prognostic factors identified at the presentation of the disease were able to predict very long survivors. Further investigations on these tumors biology and clinical trials dedicated to this population are required.
Clinical trial identification
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All authors have declared no conflicts of interest.