scholarly journals Frequency Distribution of Bone metastasis in Breast cancer: A retrospective study in Khartoum Oncology Hospital 2019

2020 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Cervical Vertebrae ◽  
Lumbar Vertebrae ◽  
Clinical Information ◽  
Thoracic Vertebrae ◽  
Common Site ◽  
Duration Of Treatment

Background: Breast cancer (BC) is a common cancer in women worldwide and leading cause of bone metastasis (BM). This study reveals the incidence of bone metastases and the most frequent BM sites secondary to BC in Khartoum Oncology Hospital. Materials and method: Retrospective study in Khartoum oncology hospital of medical record from January 2019 to September 2019. Demographic and clinical information extracted from the medical records of eligible patients in the last 5 years 2015-2019 included age, sex, social habits, duration of breast cancer, duration of treatment and location of bone metastasis. Statistical analyses were performed using SPSS, Version 22.0. (IBM, USA). Results: From all patients diagnosed with BC, 3.03% had developed BM out of whom 50% of patients developed bone metastases in 2-5 years of diagnosis of BC and 39.7% in less than 2 year of diagnosis. The median age was 54 years (range 28-78). The most common site is lumbar vertebrae (48.8%), followed by thoracic vertebrae (32.9%), pelvis 34 (32.9%), sternum (27.1%), ribs (25.7%), femur (15.7%), skull (15.7%), clavicle (14.3%), sacral vertebrae (14.3%), cervical vertebrae (12.8%), hummers (11.4%), and tibia (4.3%). Right side BC contribute to 57.1% of BM whereas left side BC to 40%. The duration of BC significantly correlates to number of distant bone metastases (P = 0.006). Conclusion: The most common site of BM in BC patients is lumbar vertebrae, the duration of BC affects development of BM, Exploring the knowledge of patient populations prone to develop bone metastasis helps in further intervention and management.

scholarly journals Comparison of the distribution pattern of metastatic bone disease and Skeletal related events between breast and prostate cancer: A retrospective study in Khartoum Oncology Hospital 2020

2020 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Prostate Cancer ◽  
Retrospective Study ◽  
Distribution Pattern ◽  
Medical Records ◽  
Clinical Information ◽  
Thoracic Vertebrae ◽  
Duration Of Treatment ◽  
Skeletal Complications ◽  
Skeletal Related Events ◽  
Breast And Prostate Cancer

Background: Bone metastasis (BM) and its consequence skeletal-related events (SREs) are the most common cause of cancer pain and disability. In this study, we compare the distribution pattern of BM and SREs in breast cancer (BC) and prostate cancer (PC). Materials and Method: A Retrospective study in Khartoum oncology hospital of the medical record from 29 September 2019 to March 2020. Demographic and clinical information extracted from the medical records of eligible patients in the last 5 years 2015-2019 included age, sex, social habits, duration of breast and prostate cancer, duration of treatment, site of BM, and SREs if present. Statistical analyses were performed using SPSS, Version 22.0. (IBM, USA). Results: Out of 3216 patients, medical records 71.8% diagnosed with BC and 28.2% diagnosed with PC.5.6% had to BM the ratio between the breast and prostate is 1:4, Both cancers commonly metastasize to Spinal and pelvic bones. In comparison between BC and PC, the common site for BM according to the affected segment is lumber 48.8%, thoracic 32.9%, and pelvic 32.9% in BC. While in the PC: 56.9%, 50.5%, and 42.2% for lumbar, pelvic, and thoracic vertebrae respectively. SREs occur in 45.7% and 63.3% of BC and PC patients respectively. Conclusion: Based on high incidence BM in the BC and PC, screening for BM as soon as cancer diagnosed should be done promptly. Skeletal complications signs should always be considered as a matter of priority, as it has an impact on patient quality of life.

The locomotor system

2013 ◽  
Author(s):  
Martin E. Atkinson
Keyword(s):  
Vertebral Column ◽  
Cervical Vertebrae ◽  
Lumbar Vertebrae ◽  
Posterior Wall ◽  
Axial Skeleton ◽  
Intervertebral Discs ◽  
Central Canal ◽  
The Body ◽  
Thoracic Vertebrae ◽  
Locomotor System

The locomotor system comprises the skeleton, composed principally of bone and cartilage, the joints between them, and the muscles which move bones at joints. The skeleton forms a supporting framework for the body and provides the levers to which the muscles are attached to produce movement of parts of the body in relation to each other or movement of the body as a whole in relation to its environment. The skeleton also plays a crucial role in the protection of internal organs. The skeleton is shown in outline in Figure 2.1A. The skull, vertebral column, and ribs together constitute the axial skeleton. This forms, as its name implies, the axis of the body. The skull houses and protects the brain and the eyes and ears; the anatomy of the skull is absolutely fundamental to the understanding of the structure of the head and is covered in detail in Section 4. The vertebral column surrounds and protects the spinal cord which is enclosed in the spinal canal formed by a large central canal in each vertebra. The vertebral column is formed from 33 individual bones although some of these become fused together. The vertebral column and its component bones are shown from the side in Figure 2.1B. There are seven cervical vertebrae in the neck, twelve thoracic vertebrae in the posterior wall of the thorax, five lumbar vertebrae in the small of the back, five fused sacral vertebrae in the pelvis, and four coccygeal vertebrae—the vestigial remnants of a tail. Intervertebral discs separate individual vertebrae from each other and act as a cushion between the adjacent bones; the discs are absent from the fused sacral vertebrae. The cervical vertebrae are small and very mobile, allowing an extensive range of neck movements and hence changes in head position. The first two cervical vertebrae, the atlas and axis, have unusual shapes and specialized joints that allow nodding and shaking movements of the head on the neck. The thoracic vertebrae are relatively immobile. combination of thoracic vertebral column, ribs, and sternum form the thoracic cage that protects the thoracic organs, the heart, and lungs and is intimately involved in ventilation (breathing).

scholarly journals Bone Metastasis Prognostic Factors in Breast Cancer

2019 ◽  
Vol 13 ◽  
pp. 117822341983097 ◽  
Author(s):  
Akram Yazdani ◽  
Sara Dorri ◽  
Alireza Atashi ◽  
Hoda Shirafkan ◽  
Hedieh Zabolinezhad
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Bone Metastasis ◽  
Lymph Nodes ◽  
Bone Metastases ◽  
Tumor Size ◽  
Menopausal Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Factors Associated

Objective: Bone is the most common site of metastasis in breast cancer. Prognostic factors for predicting bone metastases in breast cancer are controversial yet. In this study, we investigated clinical factors associated with secondary bone metastasis of breast cancer. Methods: In total, 1690 patients with breast cancer recorded between 2002 and 2012 in Motamed Cancer Institute, Tehran, Iran entered in the retrospective study. We studied age, menopausal status, histologic type, tumor size, number of cancerous axillary lymph nodes, serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA)-153, and hemoglobin (HB) in 2 groups with bone metastases (n = 123) and without it, respectively. We applied logistic regression to identify bone metastasis prognostic factors in breast cancer patients and calculated the cut-off value, sensitivity, and characteristics of independent prognostic factors using receiver operating characteristic (ROC) curve analysis. Results: Menopause, larger tumor size, and the greater number of cancerous axillary lymph nodes increased the chance of bone metastases significantly ( P < .05). There was no significant difference between mean groups with and without bone metastases regarding serum concentration of CEA, CA-153, HB, and histopathologic type ( P > .05). Logistic regression showed that age (odds ratio (OR) = 1.021), menopausal status (OR = 1.854), number of cancerous axillary lymph nodes (OR = 1.065), a tumor size between 2 and 5 cm diameter (OR = 2.002) and more than 5 cm diameter (OR = 4.009), and ALP (OR = 1.005) are independent prognostic factors associated with bone metastases. The ROC curve showed that the abovementioned factors have comparable predictive accuracy for bone metastases. Conclusions: Age, menopausal status, number of axillary lymph node metastases, tumor size, and ALP were identified as prognostic factors for bone metastasis in patients with breast cancer. So patients with these characteristics should be monitored more precisely with regular follow-ups.

scholarly journals Microenvironmental IL1β promotes breast cancer metastatic colonisation in the bone via activation of Wnt signalling

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Rachel Eyre ◽  
Denis G. Alférez ◽  
Angélica Santiago-Gómez ◽  
Kath Spence ◽  
James C. McConnell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Colony Formation ◽  
Breast Cancer Cells ◽  
Wnt Signalling ◽  
Early Event ◽  
Metastatic Lesions ◽  
Breast Cancer Bone Metastasis

Abstract Dissemination of tumour cells to the bone marrow is an early event in breast cancer, however cells may lie dormant for many years before bone metastases develop. Treatment for bone metastases is not curative, therefore new adjuvant therapies which prevent the colonisation of disseminated cells into metastatic lesions are required. There is evidence that cancer stem cells (CSCs) within breast tumours are capable of metastasis, but the mechanism by which these colonise bone is unknown. Here, we establish that bone marrow-derived IL1β stimulates breast cancer cell colonisation in the bone by inducing intracellular NFkB and CREB signalling in breast cancer cells, leading to autocrine Wnt signalling and CSC colony formation. Importantly, we show that inhibition of this pathway prevents both CSC colony formation in the bone environment, and bone metastasis. These findings establish that targeting IL1β-NFKB/CREB-Wnt signalling should be considered for adjuvant therapy to prevent breast cancer bone metastasis.

CA 15.3 with Urinary Calcium Excretion is Useful in the Diagnosis and Monitoring of Bone Metastases from Breast Cancer

1993 ◽  
Vol 8 (4) ◽  
pp. 208-214
Author(s):  
G.C. Yadav ◽  
A. Rao ◽  
M.M. Motawy ◽  
N. Safadi ◽  
M. Jameel Ahmed
Keyword(s):  
Breast Cancer ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Serum Levels ◽  
Urinary Calcium ◽  
Response To Therapy ◽  
Urinary Calcium Excretion ◽  
Calcium Excretion ◽  
Diagnostic Efficacy ◽  
Ca 15.3

Serum levels of breast carcinoma antigen (CA 15.3) and urinary calcium excretion (UCa) were determined in 73 patients with breast cancer: 36 without bone metastases (stage I-IV) and 37 with bone metastases. The patients in the latter group were further investigated at 2,4 and 6 months from the start of treatment. Both markers showed significant elevations in the group with bone metastases (CA 15.3: P = 1.0×10–6, UCa: P = 8.6×10–9). The bone metastasis index (BMI), which represents the combination of the markers, had better diagnostic efficacy (90%) than CA 15.3 alone (84%) or UCa alone (82%). During treatment of bone metastasis, the longitudinal levels of the markers showed a highly significant association with the therapeutic response assessed by the UICC criteria. For identifying progression of disease, the diagnostic efficacy of CA 15.3, UCa and a combination of both, the so-called Biochemical Index of Response (BIR), was 65%, 70% and 79%, respectively, at two months and 89%, 84% and 92% at four months. Application of the tandem, CA 15.3 with UCa, was very useful for the detection of bone metastases and the prediction of response to therapy.

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.

Skeletal metastases in advanced pancreatic ductal adenocarcinoma (PDAC): A retrospective analysis.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 245-245
Author(s):  
Akshjot Puri ◽  
John Chang ◽  
Tomislav Dragovich ◽  
Patricia Lucente ◽  
Madappa N. Kundranda
Keyword(s):  
Retrospective Analysis ◽  
Cervical Vertebrae ◽  
Lumbar Vertebrae ◽  
Skeletal Metastasis ◽  
Ductal Adenocarcinoma ◽  
Skeletal Metastases ◽  
Initial Symptom ◽  
Intractable Pain ◽  
Thoracic Vertebrae ◽  
Pathological Fractures

245 Background: Skeletal metastasis (SM) in advanced PDAC is an infrequent occurrence and has been previously reported to be < 2.5%. However; pathological fractures in these patients can result in intractable pain, immobilization and a significant deterioration in quality of life. Methods: A retrospective analysis was conducted of patients (pts) with advanced PDAC receiving palliative chemotherapy. Data collection included age, gender, ECOG, sites of disease, and overall survival (OS). Statistical analysis included Kaplan Meier survival analysis. Results: The 135 pts included had a median age of 65.8 years (range: 53.7–91.3); 5 (31.2%) were women and 11 (68.7%) had an ECOG performance status of 0 or 1. A majority of patients received combination therapy that was either gemcitabine or 5-flurouracil based. Sixteen pts (11.8%) had skeletal metastasis with the primary tumor located in the pancreatic body/tail (11 pts - 68.7%).The sites of SM included thoracic vertebrae (8), lumbar vertebrae (5), pelvis (5), ribs (4), sacrum (4), scapula (3), acetabulum (2), cervical vertebrae (2), femoral head (2), sternum (1) and humerus head (1). A majority of the lesions were osteolytic (62.5%) with a median time of diagnosis of SM from initial diagnosis being 1.25 months (range 0-33). Bone pain was observed as the initial symptom in 5 pts (32%), 1 pt (6.2%) had a pathological fracture. The mOS for patients with SM was 6.5 months (range 0-38) when compared to 8 months (range 0-147) without SM.The mOS for pts treated with gemcitabine based regimen was 5.75 months (range 2.5-14), and patients who received multiple lines of therapy including gemcitabine and 5-FU based regimens was 15 months (range 5-38). Survival from onset of skeletal metastases ranged from 0-14 months (mOS: 4 months). Conclusions: More effective systemic therapies which improve mOS are likely to result in increased incidence of SM. The most common sites observed were the thoracic and lumbar vertebrae and pathological fractures in these sites can be catastrophic. Therefore careful evaluation of skeletal signs and symptoms, early detection and intervention will be important to prevent morbidity and mortality from pathological fractures.

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 Bone Marrow Metastasis Is an Early Stage of Bone Metastasis in Breast Cancer Detected Clinically by F18-FDG-PET/CT Imaging

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Kusai M. Al-Muqbel
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Fdg Pet ◽  
Early Stage ◽  
Ct Imaging ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Objective. To determine the value of 18F-FDG PET/CT in detection of bone marrow (BM) metastasis in breast cancer which is considered an early stage of bone metastasis. Patients and Methods. Retrospectively, breast cancer patients with bone metastasis were included. BM metastasis was considered if the lesion was PET positive/CT occult while bone metastasis was considered if the lesion was PET positive/ CT positive. BM metastases were observed sequentially on F18-FDG PET/CT. Results. We included 35 patients. Eighteen patients (51%) had BM metastases in addition to other bone metastases. BM metastases comprised 24% of all lesions. Posttreatment scan was performed on 26/35 patients. Twenty-three percent of BM metastases had resolved completely without causing bone destruction after treatment. Sixty-five percent of BM metastases had converted into bone metastases after treatment. Twelve percent of BM metastases had persisted after treatment. Conclusion. This retrospective study showed clinically by 18F-FDG PET/CT imaging that BM metastasis is an early stage of bone metastasis in breast cancer. Interestingly, 18F-FDG-PET/CT showed that early eradication of individual BM metastasis by systemic treatment precluded development of bone metastasis. However, more research is needed to study the impact of an early diagnosis of BM metastases on treatment outcome.

scholarly journals Anatomo-radiographic description of the axial skeleton of the crab-eating fox (Cerdocyon thous)

2012 ◽  
Vol 32 (suppl 1) ◽  
pp. 01-03 ◽  
Author(s):  
Janaína D. Barisson ◽  
Cristiane H. Louro ◽  
Sheila J.T. Dias ◽  
Flávio S. Jojima ◽  
Murilo S. Ferreira ◽  
...  
Keyword(s):  
Cervical Vertebrae ◽  
Spinous Process ◽  
Lumbar Vertebrae ◽  
Axial Skeleton ◽  
The Other ◽  
Domestic Dog ◽  
Thoracic Vertebrae ◽  
The Third ◽  
Caudal Vertebrae ◽  
Cerdocyon Thous

The aim of this study was to describe the axial skeleton of a wild Brazilian carnivorous, the crab-eating fox (Cerdocyon thous). Five specimens of crab-eating fox were previously unfrozen for radiographic exams and their bones went through dissection and chemical maceration. This animal presents seven cervical vertebrae, and from the third on, they become shorter and wider than the other ones e the spinous process was makeable from the fifth cervical vertebrae on. There are thirteen thoracic vertebrae and the spinous process of the lumbar vertebrae, which are seven, decreases from the fifth on. The sacrum is formed by two vertebrae and there are twenty or twenty one caudal vertebrae. It can be concluded that the crab-eating fox axial skeleton is similar to that of the domestic dog.

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