title: Incidence of bone metastases and survival after a diagnosis of bone metastases in breast cancer patients.
abstract: BACKGROUND
  Bone is the most common metastatic site associated with breast cancer. Using a database of women with breast cancer treated at Guy's Hospital, London 1976-2006 and followed until end 2010, we determined incidence of and survival after bone metastases.
  
  
  METHODS
  We calculated cumulative incidence of bone metastases considering death without prior bone metastases as a competing risk. Risk of bone metastases was modelled through Cox-regression. Survival after bone metastases diagnosis was calculated using Kaplan-Meier methodology.
  
  
  RESULTS
  Of the 7064 women, 589 (22%) developed bone metastases during 8.4 years (mean). Incidence of bone metastases was significantly higher in younger women, tumour size >5 cm, higher tumour grade, lobular carcinoma and ≥ four positive nodes, but was not affected by hormone receptor status. Median survival after bone metastases diagnosis was 2.3 years in women with bone-only metastases compared with <1 year in women with visceral and bone metastases. There was a trend for decreased survival for patients who developed visceral metastases early, and proportionately fewer patients in this group.
  
  
  CONCLUSIONS
  Incidence of bone metastases has decreased but bone metastases remain a highly relevant clinical problem due to the large number of patients being diagnosed with breast cancer.
authors.affiliation: Department of Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: mark.harries@gstt.nhs.uk.
authors.forename: M
authors.initials: M
authors.lastname: Harries
authors.affiliation: Centre for Observational Research, Amgen Limited, 1 Uxbridge Business Park, Sanderson Road, Uxbridge UB8 1DH, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Taylor
authors.affiliation: King's College London School of Medicine, Division of Cancer Studies, Cancer Epidemiology Unit, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom.
authors.forename: L
authors.initials: L
authors.lastname: Holmberg
authors.affiliation: King's College London School of Medicine, Division of Cancer Studies, Cancer Epidemiology Unit, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom.
authors.forename: O
authors.initials: O
authors.lastname: Agbaje
authors.affiliation: King's College London School of Medicine, Division of Cancer Studies, Cancer Epidemiology Unit, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom.
authors.forename: H
authors.initials: H
authors.lastname: Garmo
authors.affiliation: King's College London School of Medicine, Division of Cancer Studies, Cancer Epidemiology Unit, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Kabilan
authors.affiliation: King's College London School of Medicine, Division of Cancer Studies, Research Oncology, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Purushotham
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000453:epidemiology* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000556:secondary*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D016016:Proportional Hazards Models
keywords: Bone metastases; Breast cancer; Incidence; Survival