Risk of metastasis among rib abnormalities on bone scans in breast cancer patients.
Bone scan abnormalities, especially rib lesions, are often confusing for physicians due to a high number of false-positive lesions. This study investigated risk factors that are associated with bone metastasis in 613 breast cancer patients with bone scan abnormalities. Significantly increased rates of bone metastasis were observed in patients with multiple lesions, large tumor sizes, and lymph node involvement. In addition, patients with concurrent lesions of rib and other sites exhibited a significant higher rate of metastatic disease compared to those with other site lesions (P = 0.009). In the subset of 324 patients with rib abnormalities, the rate of metastasis was extremely low in patients with pure rib lesions (1.2%; 95% CI: 0.1%-4.1%). Concurrent lesions of rib and other sites were more likely to be rib metastasis compared to pure rib lesions (P < 0.001). Moreover, multiple rib lesions and lesions located on bilateral ribs were more likely to be rib metastasis (P < 0.001). Our data suggest that patients with pure rib abnormalities could be recommended for follow-up only. However, if concurrent lesions of rib and other sites were detected on bone scans, additional radiological examinations should be performed to patients.
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Qin
Q
Li
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Zhiqiang
Z
Chen
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Yansheng
Y
Zhao
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Xiuqing
X
Li
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Hong
H
Pan
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Tiansong
T
Xia
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Lin
L
Chen
Department of Nuclear Medicine, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Zhaoqiang
Z
Xu
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Wenbin
W
Zhou
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
Xiaoan
X
Liu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis; D008875:Middle Aged; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012272:Ribs; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data*
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate