Risk factors of early bone metastasis in breast cancer patients

doi:10.3877/cma.j.issn.1674-0807.2020.02.007

Abstract

Abstract:

Objective

To explore the risk factors of early bone metastasis in breast cancer patients within postoperative two years.

Methods

The clinical data of 146 breast cancer patients with bone metastasis in the First Affiliated Hospital of Nanjing Medical University from January 2008 to December 2016 were analyzed retrospectively. The Kaplan-Meier survival curve and log-rank test were used to compare the bone metastasis-free time (BFT) among patients with different ages, tumor sizes, metastatic lymph node numbers and molecular subtypes. Cox’s proportional hazards regression model was used to analyze the risk factors of early bone metastasis.

Results

In 146 breast cancer patients with bone metastasis, the median BFT was 25.9 months (range: 0.1-201.3 months). Age ≥59 years (χ²=18.42, P<0.001), tumor stage≥T₂ (χ²=21.71, P<0.001), metastatic lymph nodes≥10(χ²=30.79, P<0.001)were risk factors of early bone metastasis in breast cancer patients. Age≥59 years, tumor stage≥T₂ and metastatic lymph nodes≥10 were identified as independent risk factors of early bone metastasis in breast cancer patients (HR=2.392, 95%CI: 1.367-4.184, P=0.002; HR=2.159, 95%CI: 1.061-4.393, P=0.034; HR=1.964, 95%CI: 1.167-3.305, P=0.011).

Conclusion

The breast cancer patients with higher age, larger diameter of primary tumor or more metastatic axillary lymph nodes are more prone to early bone metastasis.

Key words: Breast neoplasms, Neoplasm metastasis, Risk factors

Xu Chen, Le Hu, Longquan Lou, Ziyi Yu, Xiaoan Liu, Shui Wang, Yi Zhao. Risk factors of early bone metastasis in breast cancer patients[J]. Chinese Journal of Breast Disease(Electronic Edition), 2020, 14(02): 98-103.

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References 23

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变量	变量类型	变量分类及赋值
年龄	X₁	<59岁＝0，≥59岁＝1
T分期	X₂	T₁＝1，T₂＝2，T₃及以上＝3
ER	X₃	阴性＝0，阳性＝1
PR	X₄	阴性＝0，阳性＝1
HER-2	X₅	阴性＝0，阳性＝1
Ki67	X₆	≤14%＝0, >14%＝1
腋窝淋巴结转移数目	X₇	<10枚＝0，≥10枚＝1
分子分型	X₈	luminal A型＝1, luminal B型＝2, HER-2过表达型＝3,三阴性乳腺癌＝4
无骨转移时间	Y	<2年＝1，≥2年＝0

变量	变量类型	变量分类及赋值
年龄	X₁	<59岁＝0，≥59岁＝1
T分期	X₂	T₁＝1，T₂＝2，T₃及以上＝3
ER	X₃	阴性＝0，阳性＝1
PR	X₄	阴性＝0，阳性＝1
HER-2	X₅	阴性＝0，阳性＝1
Ki67	X₆	≤14%＝0, >14%＝1
腋窝淋巴结转移数目	X₇	<10枚＝0，≥10枚＝1
分子分型	X₈	luminal A型＝1, luminal B型＝2, HER-2过表达型＝3,三阴性乳腺癌＝4
无骨转移时间	Y	<2年＝1，≥2年＝0

临床病理特征		例数	构成比(%)
年龄		?	?
?	<59岁	118	80.8
?	≥59岁	28	19.2
无骨转移时间		?	?
?	<24个月	67	45.9
?	≥24个月	79	54.1
T分期		?	?
?	T₁	39	26.7
?	T₂	96	65.8
?	T₃和T₄	11	7.5
ER		?	?
?	阳性	107	73.3
?	阴性	39	26.7
PR		?	?
?	阳性	91	62.3
?	阴性	55	37.7
HER-2		?	?
?	阳性	62	42.5
?	阴性	84	57.5
Ki67		?	?
?	≤14%	33	22.6
?	>14%	113	77.4
分子分型		?	?
?	luminal A	22	15.1
?	luminal B	88	60.3
?	HER-2过表达型	19	13.0
?	三阴性	17	11.6
腋窝淋巴结转移数目		?	?
?	<10枚	106	72.6
?	≥10枚	40	27.4

临床病理特征		例数	构成比(%)
年龄		?	?
?	<59岁	118	80.8
?	≥59岁	28	19.2
无骨转移时间		?	?
?	<24个月	67	45.9
?	≥24个月	79	54.1
T分期		?	?
?	T₁	39	26.7
?	T₂	96	65.8
?	T₃和T₄	11	7.5
ER		?	?
?	阳性	107	73.3
?	阴性	39	26.7
PR		?	?
?	阳性	91	62.3
?	阴性	55	37.7
HER-2		?	?
?	阳性	62	42.5
?	阴性	84	57.5
Ki67		?	?
?	≤14%	33	22.6
?	>14%	113	77.4
分子分型		?	?
?	luminal A	22	15.1
?	luminal B	88	60.3
?	HER-2过表达型	19	13.0
?	三阴性	17	11.6
腋窝淋巴结转移数目		?	?
?	<10枚	106	72.6
?	≥10枚	40	27.4

部位		病灶数(n＝320)	占总病灶数比例(%)
颅骨		12	3.7
胸部骨骼		98	30.6
?	肩胛骨	6	1.9
?	锁骨	5	1.5
?	胸骨	31	9.7
?	肋骨	56	17.5
脊柱椎体		113	35.3
?	腰椎	44	13.8
?	胸椎	65	20.3
?	颈椎	4	1.2
骨盆		69	21.6
?	骶骨及骶髂处	37	11.6
?	髂骨	28	8.8
?	坐骨	4	1.2
?	耻骨	0	0
肢体		28	8.8
?	上肢骨	6	1.9
?	下肢骨	22	6.9

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