Metastatic Breast Cancer at a Glance: Scenarios of BC Brain- and BC Bone-Metastasis by Illustrations

2017 ◽  
pp. 1029-1070
Author(s):  
Parvin Mehdipour
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Metastatic Breast

scholarly journals Karakteristik Klinikopatologik Pasien Kanker Payudara dengan Metastasis Tulang di RSUP Sanglah pada Tahun 2014 - 2018

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Putu Krishna B. S. Putra ◽  
I Wayan J. Sumadi ◽  
Ni Putu Sriwidyani ◽  
IG Budhi Setiawan
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Invasive Carcinoma ◽  
Molecular Subtype ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Luminal B ◽  
Histopathological Type

Abstract: Breast cancer is the most common cancer in woman. Metastasis often occurs especially to the bones. This study was aimed to determine the characteristics of breast cancer patients with bone metastasis. This was a descriptive study with a cross-sectional design. Samples were 46 breast cancer patients with bone metastasis recorded at Sanglah Hospital from 2014 until 2018. Data of pathological examination archives of Oncology Surgery Division Medical Faculty of Udayana University/Sanglah General Hospital were used to obtain the clinicopathological characteristics of metastatic breast cancer patients based on age, lateralization, histopathological type, and tumor molecular subtype. The results showed that most cases of metastatic breast cancer were aged 40-49 years as many 21 patients (45.7%), minimal difference in lateralization between right breast as many 22 patients (47.8%) and left breast 23 patients (50%). The most common histopathological type was invasive carcinoma of no special type as many 34 patients (73.9%). The most common tumor subtype was the luminal B subtype as many 21 patients (45.7%). In conclusion, most patients of breast cancer with bone metastasis were 40-49 years old, invasive carcinoma of no special type, molecular subtype of luminal B, and no significant difference between lateralization to the right and left breast.Keywords: breast cancer, bone, metastasis, clinicopathological caharacteristics Abstrak: Kanker payudara merupakan jenis kanker yang paling sering dijumpai pada wanita. Metastasis sering terjadi terutama pada tulang. Penelitian ini bertujuan untuk mengetahui karakteristik pasien kanker payudara dengan metastasis tulang di RSUP Sanglah Denpasar. Jenis penelitian ialah deskriptif dengan desain potong lintang. Sampel penelitian ialah 46 pasien kanker payudara dengan metastasis tulang yang tercatat di RSUP Sanglah tahun 2014-2018. Data diambil dari arsip hasil pemeriksaan patologi di Subdivisi Bedah Onkologi, Departemen/Kelompok Staf Medis (KSM) Bedah Fakultas Kedokteran Universitas Udayana (FK UNUD)/RSUP Sanglah untuk mendapatkan karakteristik klinikopatologi pasien kanker payudara metastasis tulang berdasarkan usia, lateralisasi, tipe histopatologik, dan subtipe molekuler tumor. Hasil penelitian menunjukkan kasus terbanyak terjadi pada rentang usia 40-49 tahun sebanyak 21 orang (45,7%), dengan lateralisasi tidak jauh berbeda antara payudara kanan sebanyak 22 orang (47,8) dan kiri sebanyak 23 orang (50%). Tipe histopatologik yang lebih sering ditemukan yaitu invasive carcinoma of no special type sebanyak 34 orang (73,9%). Subtipe molekuler yang paling banyak ditemukan ialah subtipe luminal B sebanyak 21 orang (45,7%). Simpulan penelitian ini pasien kanker payudara dengan metastasis tulang berada pada rentang usia 40-49 tahun, invasive carcinoma of no special type, subtipe molekuler luminal B. dan lateralisasi payudara kanan dan kiri tidak jauh berbeda.Kata kunci: kanker payudara, metastasis, tulang, karakteristik klinikopatologik

scholarly journals Breast Subtypes and Prognosis of Breast Cancer Patients With Initial Bone Metastasis: A Population-Based Study

2020 ◽  
Vol 10 ◽  
Author(s):  
Deyue Liu ◽  
Jiayi Wu ◽  
Caijin Lin ◽  
Lisa Andriani ◽  
Shuning Ding ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Metastatic Breast ◽  
Risk Groups ◽  
Population Based ◽  
Breast Cancer Patients

BackgroundMetastatic breast cancer (MBC) is a highly heterogeneous disease and bone is one of the most common metastatic sites. This retrospective study was conducted to investigate the clinical features, prognostic factors and benefits of surgery of breast cancer patients with initial bone metastases.MethodsFrom 2010 to 2015, 6,860 breast cancer patients diagnosed with initial bone metastasis were analyzed from Surveillance, Epidemiology, and End Results (SEER) database. Univariate and Multivariable analysis were used to identify prognostic factors. A nomogram was performed based on the factors selected from cox regression result. Survival curves were plotted according to different subtypes, metastatic burdens and risk groups differentiated by nomogram.ResultsHormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) positive patients showed the best outcome compared to other subtypes. Patients of younger age (<60 years old), white race, lower grade, lower T stage (<=T2), not combining visceral metastasis tended to have better outcome. About 37% (2,249) patients received surgery of primary tumor. Patients of all subtypes could benefit from surgery. Patients of bone-only metastases (BOM), bone and liver metastases, bone and lung metastases also showed superior survival time if surgery was performed. However, patients of bone and brain metastasis could not benefit from surgery (p = 0.05). The C-index of nomogram was 0.66. Cutoff values of nomogram point were identified as 87 and 157 points, which divided all patients into low-, intermediate- and high-risk groups. Patients of all groups showed better overall survival when receiving surgery.ConclusionOur study has provided population-based prognostic analysis in patients with initial bone metastatic breast cancer and constructed a predicting nomogram with good accuracy. The finding of potential benefit of surgery to overall survival will cast some lights on the treatment tactics of this group of patients.

scholarly journals Bone metastasis pattern in initial metastatic breast cancer: a population-based study

2018 ◽  
Vol Volume 10 ◽  
pp. 287-295 ◽  
Author(s):  
Zhenchong Xiong ◽  
Guangzheng Deng ◽  
Xinjian Huang ◽  
Xing Li ◽  
Xinhua Xie ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Metastatic Breast ◽  
Population Based ◽  
Population Based Study

scholarly journals Clinical Features and Serological Markers Risk Model Predicts Overall Survival in Patients Undergoing Breast Cancer and Bone Metastasis Surgeries

2021 ◽  
Vol 11 ◽  
Author(s):  
Haochen Mou ◽  
Zhan Wang ◽  
Wenkan Zhang ◽  
Guoqi Li ◽  
Hao Zhou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Clinical Features ◽  
Serum Alkaline Phosphatase ◽  
External Validation ◽  
Elevated Serum ◽  
Metastatic Breast ◽  
Calibration Plot ◽  
Breast Cancer Bone Metastasis

BackgroundSurgical therapy of breast cancer and bone metastasis can effectively improve the prognosis of breast cancer. However, after the first operation, the relationship between preoperative indicators and outcomes in patients who underwent metastatic bone surgery remained to be studied. Purpose 1. Recognize clinical and laboratory prognosis factors available to clinical doctors before the operation for bone metastatic breast cancer patients. 2. Develop a risk prediction model for 3-year postoperative survival in patients with breast cancer bone metastasis.MethodsFrom 2014 to 2020, patients who suffered from breast cancer bone metastasis and received therapeutic procedures in our institution were included for analyses (n=145). For patients who underwent both breast cancer radical surgery and bone metastasis surgery, comprehensive datasets of the parameters of interest (clinical features, laboratory factors, and patient prognoses) were collected (n=69). We performed Multivariate Cox regression to identify factors that were associated with postoperative outcome. 3-year survival prediction model and nomograms were established by 100 bootstrapping. Its benefit was evaluated by calibration plot, C-index, and decision curve analysis. The Surveillance, Epidemiology, and End Results database was also used for external validation.ResultsRadiotherapy for primary cancer, pathological type of metastatic breast cancer, lymph node metastasis, elevated serum alkaline phosphatase, lactate dehydrogenase were associated with postoperative prognosis. Pathological types of metastatic breast cancer, multiple bone metastasis, organ metastases, and elevated serum lactate dehydrogenase were associated with 3-year survival. Then those significant variables and serum alkaline phosphatase counts were integrated to construct nomograms for 3-year survival. The C-statistic of the established predictive model was 0.83. The calibration plot presents a graphical representation of calibration. In the decision curve analysis, the benefits are higher than those of the extreme curve. The receiver operating characteristic of the external validation of the model was 0.82, indicating a favored fitting degree of the two models.ConclusionOur study suggests that several clinical features and serological markers can predict the overall survival among the patients who are about to receive bone metastasis surgery after breast cancer surgery. The model can guide the preoperative evaluation and clinical decision-making for patients. Level of evidence Level III, prognostic study.

Assisting decision making on the use of carboplatin for metastatic breast cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13008-e13008
Author(s):  
Juan Luis Gomez Marti ◽  
Margaret Q. Rosenzweig ◽  
Adam Brufsky
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Metastatic Breast ◽  
Clinical Information ◽  
Her2 Status ◽  
Visceral Metastasis ◽  
Hormonal Therapies ◽  
Current Guidelines ◽  
Metastatic Location

e13008 Background: Metastatic breast cancer (MBC) is currently treated with chemotherapy, often in combination with targeted or hormonal therapies. Current guidelines indicate the use of paclitaxel in combination with HER2-targeted therapy for HER2+ disease. Platins are often used in combination with taxanes for HER2+, and rarely for HER2(-), metastatic disease. While some studies reported no benefit from carboplatin (Carbo), others showed an additive effect in combination with a taxane (Txn). At this time, it is not clear if platins are an effective course of treatment for HER2+bone only disease. Therefore, this study investigates in a real-world clinical setting the utility of Carbo after the diagnosis of a first metastasis. Methods: Clinical information was obtained using a database with MBC patients seen at Magee Women’s Hospital from 1999-2019. After a chart review, patients were initially classified according to their molecular status and first metastatic location. Overall survival (OS) and time to next therapy (TTNT) were measured (months) and compared between those who received Txn and those who received Carbo in combination with a Txn after first metastatic diagnosis. Treatment response was investigated in either bone or visceral (lung or liver) MBC. Log ranks were used to estimate survival. Results: From 1,723 patients, 36.15% developed first metastasis to bone, 8.7% to lung, 12.63% to lymph node, 9.46% to liver, 4.17% to brain, and 23.33% to other sites. We found that HER2+ patients firstly diagnosed with visceral metastasis benefited from Carbo+Txn vs Txn only (OS 53.27 vs 38.17, P = 0.034), but not those who were HER2(-) (OS 23.20 vs 25.03, P = 0.307), or with bone metastasis, regardless of HER2 status (OS 38.57 vs 37.13, P = 0.718). However, patients with bone metastasis showed an increased TTNT with Carbo+Txn vs Txn alone (13.68 vs 8.167, P = 0.007). Finally, patients with liver metastasis who received Carbo+Txn had an increased OS (51.7 vs 20.4, P = 0.01) and TTNT (17.33 vs 8.63, P = 0.02) compared to Txn only. Looking separately at HER2 status, we found a nonsignificant trend towards Carbo+Txn efficacy in both subtypes. No differences in OS were found when looking at lung as the first metastatic location (Carbo+Txn vs Txn, 30.67 vs 27.03, P = 0.75). Conclusions: Patients whose first metastasis is to the liver, and those who are HER2+ and develop visceral metastasis, might benefit from carboplatin in combination with a taxane and HER2-targeted therapies. There is no benefit from adding carboplatin for bone metastasis. Further studies with larger datasets could validate these results.

GLPG0187 inhibits progression of established bone metastasis and achieves maximum efficacy when combined with standard-of-care metastatic breast cancer treatments

Bone ◽  
2011 ◽  
Vol 48 (1) ◽  
pp. S45 ◽  
Author(s):  
P. Clément-Lacroix ◽  
E. Berrocal ◽  
B. Heckmann ◽  
P. Wigerinck ◽  
G. Lorenzon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Metastatic Breast ◽  
Standard Of Care ◽  
Cancer Treatments

scholarly journals De novo Stage IV Luminal Breast Cancer: Yes or No for Local Treatment? Serial Cases and Review

2021 ◽  
Vol 9 (B) ◽  
pp. 1-5
Author(s):  
Marija Karakolevska-Ilova ◽  
Elena Simeonovska Joveva ◽  
Aleksandar Serafimov
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Retrospective Studies ◽  
De Novo ◽  
Metastatic Breast ◽  
Stage Iv ◽  
Additional Surgery ◽  
Stage Iv Breast Cancer

BACKGROUND: Primary stage IV breast cancer accounts about of 3–5% of newly diagnosed breast cancer cases. The management of this patient subset mostly comprises systemic therapy, with additional surgery or radiotherapy to control locoregional symptoms. Some of the retrospective studies showed the benefit of locoregional treatment as the first treatment of choice for overall survival (OS), but the efficacy of primary site surgery remains controversial for OS in prospective, controlled trials. AIM: We aimed to presents series of cases with primary metastatic breast cancer with diffuse bone metastasis. MATERIALS AND METHODS: This study was serial of cases with primary metastatic breast cancer with diffuse bone metastasis and a review of the literature. All of the cases were treated with upfront surgical resection of the primary in the breast. RESULTS: During the follow-up period of 36 months, all of our patients were still alive. CONCLUSION: Retrospective studies about resection of primary tumor as the first treatment of choice are with conflicting results, which may be related to randomization bias, including different biological types of breast cancer, different metastatic sites, and patients with different menopausal status. On the other hand, prospective studies did not show any powerful results that would lead the treatment in de novo stage IV breast cancer because of few limitations such a short follow-up period (between 23 and 40 months), younger patients, ER-positive/HER2 negative tumors, and type of chemotherapy given or not upfront. The effect of upfront surgery in newly metastatic breast cancer patients is still challenging, so there is a need to identify the exact cohort of patients who could benefit from surgery.

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