Multicenter Italian bone metastasis database: First prospective data on breast cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13072-e13072
Author(s):  
Alberto Bongiovanni ◽  
Flavia Foca ◽  
Manuela Fantini ◽  
Rosachiara Forcignano ◽  
Fabrizio Artioli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Disease Diagnosis ◽  
Stage Iii ◽  
Breast Cancer Patients ◽  
Prospective Data ◽  
Luminal B

e13072 Background: Bone Metastases (BM) are still the main cause of morbidity and morbility in cancer patients because of their complications defined as skeletal-related events (SREs).SREs reduce pts quality of life and are associated with an increasing in social and health costs. At present, data concerning BM are mainly obtained retrospectively from monocentric experiences. Methods: We performed a multicentre prospective observational study of patients with BM from breast cancer (BC) with at least 6 month (m)'s follow-up who were registered in a prospective BM database (BMDB). Detailed information on patients at first diagnosis of BM was recorded in a custom-built software system, updated every 6 m by participating centres and reviewed by the coordinator centre.All pts have signed an informed consent. Results: Since October 2014,618 pts with BM from solid tumors were enrolled of whom 220 have BC as primitive site with a 6 m follow-up. Median age was 62 y (range 26-86). Median Follow up was 34 m (6-149). At enrolment 109 (50%) had only BM and 109 (50%) pts had concomitant visceral and BM. Median time to first BM was 47 m (range 0-312) in Bone only disease and 78.6 m in pts with visceral bone metastases. Disease Free interval (DFI) was different according to BC molecular subtypes and stage. The univariate hazard ratio (HR) for visceral or bone metastasis was higher in luminal B tumors (1.56, 95% confidence interval [CI]:1.1-2.3) (p = 0.002), basal-like (2.50, 95% CI:1.1-6.0) (p = 0.043), and HER2-enriched tumors (1.37, 95% CI:0.78-2.4) (p = 0.273). DFI for pts with stage I disease at diagnosis of primary BC was longer than that for stage III pts (median 67.2 m, 95%CI:53.1-96.1, vs. 58.1 m, 95%CI:41.9-73.4), with a HR of 1.84 (95% CI:1.1-3.0) (p = 0.015) for the stage III group, and 0.98 (95% C.I.:0.6-1.5) (p = 0.930) for the stage II group. During BM disease, 98 pts had at least 1 SREs . Zoledronate was used in 69.1% and Denosumab in 28.3% of cases. First line treatment was hormone-based (n = 105, 50.7%) chemo-based therapy (n = 80, 38.7%) and chemo+ormono based (n = 20, 9.7%). During follow up progression disease occurred in 167 pts. Median progression-free (mPFS) and overall survival calculated from metastatic disease diagnosis (mOS) were 15.1 m (95%CI 12.6-18.4) and 66.8 m (95%CI 52.1-79.2),respectively. Conclusions: This study presents prospective data about a cohort of BC pts enrolled at the first BM occurrence and followed over the time, extrapolated by the multicentric observational BMDB in order to better understed the clinical history of breast cancer and bone metastases.

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

PTHrP(12-48) for the diagnosis of breast cancer bone metastasis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21039-e21039
Author(s):  
Charity L. Washam ◽  
Stephanie D. Byrum ◽  
Kim Leitzel ◽  
Ali M. Suhail ◽  
Allan Lipton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Statistical Significance ◽  
Breast Cancer Patients ◽  
Parathyroid Hormone Related Protein ◽  
Increased Risk ◽  
Breast Cancer Bone Metastasis

e21039 Background: Bone metastasis of breast cancer significantly compromises patient morbidity and mortality. Currently, no reliable methods detect or predict patients at increased risk for developing bone metastasis. We utilized 3 independent cohorts of breast cancer patients to validate a highly discriminatory plasma-based proteomic profile that identifies breast cancer bone metastasis. The identity of the most discriminatory protein component identified was a parathyroid hormone-related protein fragment, PTHrP(12-48). Methods: Plasma samples collected from 21 breast cancer patients with clinical evidence of a bone metastasis and 21 patients with no evidence of bone metastasis from time of diagnosis to clinical outcome were evaluated. A novel mass spectrometry-based assay using human serum spiked with synthetic PTHrP(12-48) was used to measure PTHrP(12-48) concentrations (pg/μl). Statistical significance was assessed by one-way ANOVA. ROC curves evaluated the diagnostic potential of PTHrP(12-48) and a simple logistic regression derived from the combined measurement of PTHrP(12-48) and NTx. Results: PTHrP(12-48) concentrations ranged between 11.6 and 92.1 pg/μl in bone metastasis patients and between 4.5 and 34.2 pg/μl in patients without bone metastases. PTHrP(12-48) was significantly increased in bone metastasis plasma (p < 0.05). No significant correlation was identified between PTHrP(12-48) and NTx. ROC analysis of PTHrP(12-48), threshold 18 pg/μl, classified the two groups with high accuracy. Class prediction by the PTHrP(12-48)/NTx logistic regression model increased diagnostic specificity. Conclusions: The measurement of PTHrP(12-48) in patient plasma has potential as a viable clinical measure of bone metastasis. In combination with serum NTx, PTHrP(12-48) may assist in identifying bone metastases in patients presenting with low to normal bone turnover markers.

scholarly journals Prognostic significance of plasma osteopontin level in breast cancer patients

2015 ◽  
Vol 6 (1) ◽  
pp. 27-32
Author(s):  
Hanan R. Nassar ◽  
Alfred E. Namour ◽  
Hanan E. Shafik ◽  
Amr S. El Sayed ◽  
Samar M. Kamel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Biochemical Marker ◽  
Menopausal Status ◽  
P Value ◽  
Breast Cancer Patients ◽  
Pathological Type ◽  
Significant Difference

Abstract Many studies have demonstrated that osteopontin (OPN) contributes functionally to aggressive behaviour in many tumours including breast cancer. This study aims to investigate its role as a simple biochemical marker easily measured in plasma of breast cancer patients to give an early signal for metastases and to detect its relationship to clinicopathological findings and survival. We measured plasma OPN, CA15.3 and serum alkaline phosphatase (ALP) activity in 55 patients, 28 with early stage breast cancer and 27 with bone metastasis out of whom 20 had metastasis in other sites. The median age at diagnosis for non-metastatic cases was 60 years (range 35-85) and for metastatic cases was 45.5 years (range 32-59). In the non-metastatic group, 78.57% of the patients were histologically graded as grades I and II and 21.43% as grade III tumours. In the metastatic group, 81.48% of the patients had grades I and II and 18.52% had grade III tumours; 54% of patients in the non-metastatic group were at stage II and 46% were at stage III at presentation. All patients of group II had bone metastasis, 33% had liver metastases, 25.9% had lung metastasis and 14.8% had lymph node metastasis. Patients with non-metastatic disease had a median OPN level of 55 ng/ml (range 54-150 ng/l), while those in the metastatic group had a median of 148.0 ng/l (range 56.0-156.0 ng/l), a difference which was statistically significant (P = 0.001). There was no statistically significant difference in the median levels of CA15.3 and ALP between both groups. The median OPN level was significantly higher with serum ALP level above 90, progesterone receptor (PR) status, bone and visceral metastasis. Median OPN was not affected significantly by menopausal status (P-value 0.3), tumour grade (P-value 0.3), estrogen receptor (ER) status (P-value 0.7), pathological type (P-value 0.42) or serum CA15.3 level (P-value 0.6). At the end of 12-year follow-up, 83% of the patients survived (92.3% in the non-metastatic versus 74.1% in the metastatic group). The estimated median survival for the whole study population at 12 years was 13 years (95% CI 8.144-17.856). The estimated median survival was 13 years (95% CI 0) and 12 years (95% CI 4.893-19.11) in patients with median OPN levels of <142 and ≥142, respectively, a difference which was not statistically significant (P = 0.343). No statistically significant difference in overall survival OS was noticed in relation to menopausal status (P = 0.7), pathological type (P = 0.4) and hormone receptor status (P = 0.3). At 6-year follow-up, it was found that OS was affected by the presence of visceral metastasis, tumour grade, serum plasma level of ALP and the serum level of CA15.3 (P = 0.0006, 0.007, 0.001 and 0.03, respectively). However, the presence of bone metastasis did not affect OS (P = 0.6). Osteopontin level can be a simple biochemical marker easily measured in plasma of breast cancer patients to give early signals for metastases, but not a prognostic factor for survival.

Irradiation of bone metastases in breast cancer patients: a randomized study with 1 year follow-up

1995 ◽  
Vol 34 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Bente Rasmusson ◽  
Ilse Vejborg ◽  
Anders Bonde Jensen ◽  
Michael Andersson ◽  
Anne-Marie Banning ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Randomized Study ◽  
Breast Cancer Patients

scholarly journals Selenium donors inhibits osteoclastogenesis through inhibiting IL-6 and plays a pivotal role in bone metastasis from breast cancer

2020 ◽  
Vol 9 (4) ◽  
pp. 544-551
Author(s):  
Luyan Zhang ◽  
Xifa Wu ◽  
Yong Feng ◽  
Linlin Zheng ◽  
Jinbo Jian
Keyword(s):  
Breast Cancer ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Cancer Cells ◽  
Cancer Patients ◽  
Cellular Level ◽  
Cancer Prognosis ◽  
Breast Cancer Patients ◽  
Dietary Selenium ◽  
Organic Selenium

Abstract Bone metastases are a frequent complication of breast cancer, and there has been little progress in the treatment of breast cancer patients with bone metastases. The cytotoxicity of selenium donors, including organic selenium and selenium nanoparticles (SeNPs), to cancer cells has been reported previously, but their relationship with bone metastases progression is not fully clear yet. In this study, multicenter clinical exploration was conducted to obtain dietary selenium intakes of breast cancer patients with or without bone metastasis, to study the relationship between selenium and breast cancer prognosis and bone metastasis. We found that dietary selenium intakes were significantly lower in breast cancer patients with bone metastasis, comparing with the non-bone metastasis cases. Selenium lower group of bone metastasis breast cancer patients had worse prognosis, whereas the daily selenium intakes could not predict the prognosis of breast cancer patients without bone metastasis. Subsequently, we study the regulatory role of selenium donors on bone metastasis at the cellular level, by challenging the cells with SeNPs. SeNPs showed potent cytotoxicity in breast cancer cells, no matter whether they were primary or bone-metastatic. SeNPs treated cancer cell inhibited the survival and differentiation of osteoclast progenitor cells. At the molecular level, we demonstrated that IL-6 partially mediated osteoclastogenesis suppression by SeNPs. These results provide a new way for biomarkers or drug development to treat and even prevent bone metastases of breast cancer by using selenium donors.

scholarly journals First prospective data on breast cancer patients from the multicentre italian bone metastasis database

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alberto Bongiovanni ◽  
Flavia Foca ◽  
Manuela Fantini ◽  
Maria Rosachiara Forcignanò ◽  
Fabrizio Artioli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Molecular Subtype ◽  
Breast Cancer Patients ◽  
Prospective Data ◽  
Disease Free Interval ◽  
History Of ◽  
Skeletal Related Events

AbstractBone metastases (BM) are still the main cause of morbidity in cancer patients because of skeletal-related events (SREs) that reduce quality of life. They have also led to increased social and healthcare costs. At present, data available on BM are insufficient. This was a multicentre prospective observational study of patients with BM from breast cancer (BC) with at least 6 months’ follow-up. Information on patients at the first diagnosis of BM, including demographics and characteristics of the primary tumor and BM. Data were periodically updated by participating centres and reviewed by the coordinator centre. From October 2014 to July 2019, 618 patients with BM from solid tumors were enrolled and 220 were eligible for the present study. Median age was 62 years (range 26–86). Median follow-up was 34 months (range 6–149). At the time of enrolment, 109 (50%) had only BM (BOM) and 109 (50%) had concomitant visceral lesions and BM (BVM). Median time-to-first BM was 47 months (range 0–312) in BOM and 78.6 months in BVM patients. Disease-free interval differed on the basis of BC molecular subtype and stage. Ninety-eight BM patients had at least on SRE. Zoledronate was used in 69.1% of cases and denosumab in 28.3%. First-line treatment was hormone-based (50.7%), chemotherapy-based (38.7%) or chemotherapy- + hormone therapy-based (9.7%). Median progression-free and overall survival were 15.1 months (95% CI 12.6–18.4) and 66.8 months (95% CI 52.1–79.2), respectively. Our prospective study could substantially help to better understand the natural history of BM from BC.

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

Long-Term Follow-Up for Locally Advanced and Inflammatory Breast Cancer Patients Treated With Multimodality Therapy

2004 ◽  
Vol 22 (20) ◽  
pp. 4067-4074 ◽  
Author(s):  
Jennifer A. Low ◽  
Arlene W. Berman ◽  
Seth M. Steinberg ◽  
David N. Danforth ◽  
Marc E. Lippman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Inflammatory Breast Cancer ◽  
Locally Advanced ◽  
Stage Iii ◽  
Breast Cancer Patients ◽  
Stage Iiia ◽  
Stage Iii Breast Cancer

Purpose To determine long-term event-free (EFS) and overall survival (OS) for patients with stage III breast cancer treated with combined-modality therapy. Patients and Methods Between 1980 and 1988, 107 patients with stage III breast cancer were prospectively enrolled for study at the National Cancer Institute and stratified by whether or not they had features of inflammatory breast cancer (IBC). Patients were treated to best response with cyclophosphamide, doxorubicin, methotrexate, fluorouracil, leucovorin, and hormonal synchronization with conjugated estrogens and tamoxifen. Patients with pathologic complete response received definitive radiotherapy to the breast and axilla, whereas patients with residual disease underwent mastectomy, lymph node dissection, and radiotherapy. All patients underwent six additional cycles of adjuvant chemotherapy. Results OS and EFS were obtained with a median live patient follow-up time of 16.8 years. The 46 IBC patients had a median OS of 3.8 years and EFS of 2.3 years, compared with 12.2 and 9.0 years, respectively, in stage IIIA breast cancer patients. Fifteen-year OS survival was 20% for IBC versus 50% for stage IIIA patients and 23% for stage IIIB non-IBC. Pathologic response was not associated with improved survival for stage IIIA or IBC patients. Presence of dermal lymphatic invasion did not change the probability of survival in clinical IBC patients. Conclusion Fifteen-year follow-up of stage IIIA and inflammatory breast cancer is rarely reported; IBC patients have a poor long-term outlook.

scholarly journals Reduced risk of metastatic breast cancer recurrence after bone fractures

2020 ◽  
Author(s):  
Nadia Obi ◽  
Stefan Werner ◽  
Frank Thelen ◽  
Klaus Pantel
Keyword(s):  
Breast Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Bone Fractures ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Insurance Fund ◽  
Breast Cancer Patients ◽  
Positive Effects

Abstract Recent experimental studies indicate that bone fractures result in the release of cytokines and cells that promote metastasis. Obtaining observational data on bone fractures after breast cancer diagnosis related to distant breast cancer recurrence risk could help determine whether fall prevention strategies can contribute to reduce breast cancer mortality. We used data from the largest German statutory health insurance fund (Techniker Krankenkasse) in a population-based cohort study of breast cancer patients diagnosed between January 2015 and November 2019. ICD-10 codes were documented monthly to quarterly. Fractures diagnosed simultaneous or after the initial breast cancer and metastases diagnosed initially from half a year later on served as exposure and outcome, respectively. The risk of regional, distant non-bone or bone metastasis related to a fracture was modelled by adjusted conditional logistic regression analysis. Of 154,000 breast cancer patients, 82,039 had a follow-up time of more than half a year. During follow-up, fractures were diagnosed in 11,900 (14.5%) patients and regional or distant metastases occurred in 7,011 (8.5%). The risk for a metastasis was reduced in patients, who had a fracture (OR 0.57, 95% CI 0.53, 0.62) compared to patients without, particularly for lymph node metastasis and moderately less pronounced in bone-metastasis (OR 0.69, 95% CI 0.61, 0.79). In view of the positive effects of sports on health of cancer survivors, the present results will decrease the anxiety of breast cancer patients that risking bone fractures might have a negative impact on their disease-specific outcome.

Sign in / Sign up

Export Citation Format

Share Document