title: Bone metastases from breast carcinoma: histopathological - radiological correlations and prognostic features.
abstract: The aim of this study was to identify factors that may be associated with the development of bone metastases in patients with metastatic breast carcinoma and to see if any of these factors had a bearing on subsequent survival. In total, 492 patients presented to the Nottingham City Hospital with metastatic breast carcinoma between July 1997 and December 2001. Of these, 267 patients had bone metastases at presentation with metastatic disease, 91 patients in this group had bone as their only site of metastatic disease. Sites of first presentation of metastatic disease were prospectively recorded, as were histological features of the primary tumour (tumour type, histological grade, lymph node stage, tumour size and oestrogen receptor (ER) status). The radiological features of the bone metastases, the metastasis-free interval and serological tumour marker levels at presentation with metastases were all recorded. There was a significant association between the development of bone metastases and lower grade tumours (P=0.019), ER-positive tumours (P<0.0001) and the lymph node stage of the primary tumour (P=0.047). A multivariate analysis found that metastasis-free interval, additional sites of metastatic disease other than bone, ER status and serological tumour marker levels all independently contributed to survival from time of presentation with bone metastases.
authors.affiliation: Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. jonathan.james@nibec.co.uk
authors.forename: J J
authors.initials: JJ
authors.lastname: James
authors.forename: A J
authors.initials: AJ
authors.lastname: Evans
authors.forename: S E
authors.initials: SE
authors.lastname: Pinder
authors.forename: E
authors.initials: E
authors.lastname: Gutteridge
authors.forename: K L
authors.initials: KL
authors.lastname: Cheung
authors.forename: S
authors.initials: S
authors.lastname: Chan
authors.forename: J F R
authors.initials: JF
authors.lastname: Robertson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000951:Antigens, Neoplasm / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D001859:Bone Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000556:secondary*; D001943:Breast Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000473:pathology*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018396:Mucin-1 / Q000032:analysis; D011379:Prognosis; D011446:Prospective Studies; D011877:Radionuclide Imaging; D011960:Receptors, Estrogen / Q000032:analysis; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D018396:Mucin-1; D011960:Receptors, Estrogen