title: Clinical characteristics and outcome of bone-only metastasis in inflammatory and noninflammatory breast cancers.
abstract: BACKGROUND
  Inflammatory breast cancer is a rare and aggressive presentation of breast cancer. Bone is a common metastatic site in breast cancer, and bone-only metastatic disease is clinically considered to have a better prognosis than visceral metastasis. However, bone-only metastasis in IBC (bone-only IBC) has not been compared with bone-only metastasis in non-IBC (bone-only non-IBC) in terms of clinical features and outcome. Because of the intrinsically aggressive nature of IBC, we hypothesized that bone-only IBC has a poorer prognosis than does bone-only non-IBC.
  
  
  METHODS
  We retrospectively identified patients with stage III primary diagnosed breast cancer who, between January 1997 and December 2012, had a first recurrence located only in the bone. Among the 197 patients that we defined as a study cohort, 50 patients had IBC and 147 patients had non-IBC. Progression-free survival (PFS) and overall survival (OS) from the date of recurrence were estimated using the Kaplan-Meier method, and patient characteristic groups were compared using the log-rank test.
  
  
  RESULTS
  OS did not differ significantly between the 2 groups (P = .2467), but a shorter PFS was seen in patients with bone-only IBC than in patients with bone-only non-IBC (P = .0357). Among patients with estrogen receptor (ER)-positive disease, a much shorter PFS was seen in bone-only IBC than in bone-only non-IBC (P = .0159).
  
  
  CONCLUSIONS
  Bone-only IBC has a poorer prognosis than does bone-only non-IBC, particularly in those with ER-positive tumors. We might need to consider more aggressive intervention (e.g., chemotherapy) for IBC patients with ER-positive bone-only metastatic disease.
authors.affiliation: Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Megumi
authors.initials: M
authors.lastname: Kai
authors.affiliation: Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kogawa
authors.affiliation: Department of Biostatistics, The University Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Diane D
authors.initials: DD
authors.lastname: Liu
authors.affiliation: Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Tamer M
authors.initials: TM
authors.lastname: Fouad
authors.affiliation: Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Kazuharu
authors.initials: K
authors.lastname: Kai
authors.affiliation: Departments of Breast and Endocrine Surgery Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Niikura
authors.affiliation: Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Limin
authors.initials: L
authors.lastname: Hsu
authors.affiliation: Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Jie S
authors.initials: JS
authors.lastname: Willey
authors.affiliation: Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Theriault
authors.affiliation: Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.affiliation: Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX. Electronic address: nueno@mdanderson.org.
authors.forename: Naoto T
authors.initials: NT
authors.lastname: Ueno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: Advanced breast cancer; Bone metastasis; Hormone receptor positivity; Overall survival; Progression-free survival