title: Incidence, consequences and treatment of bone metastases in breast cancer patients-Experience from a single cancer centre.
abstract: BACKGROUND
  There is a paucity of literature about the benefits of bone-targeted agents for breast cancer patients with bone metastases treated in the non-trial setting. We explored the incidence, consequences, and treatment of bone metastases at a single cancer centre.
  
  
  METHODS
  Electronic records of metastatic breast cancer patients were reviewed and pertinent information was extracted.
  
  
  RESULTS
  Of 264 metastatic breast cancer patients, 195 (73%) developed bone metastases. Of these patients, 176 were eligible for analysis. Median age at bone metastases diagnosis was 56.9 years (IQR 48-67) and initial presentation of bone metastases included asymptomatic radiological findings (58%), bone pain (40%), or a SRE (12.5%). Most patients (88%) received a bone-targeted agent, starting a median of 1.5 months (IQR 0.8-3.30) after bone metastasis diagnosis. 62% of patients had ≥1 SRE. The median time from bone metastasis diagnosis to first SRE was 1.8 months (IQR 0.20-8.43 months). Median number of SREs per patient was 1.5 (IQR 0-3). Overall, 26.8% of all SREs were clinically asymptomatic. Within the entire cohort, 51% required opioids and 20% were hospitalized due to either an SRE or bone pain.
  
  
  CONCLUSIONS
  Despite extensive use of bone-targeted agents, the incidence of SREs remains high. Nearly half of SREs occur prior to starting a bone-targeted agent. Use of opioids and hospitalizations secondary to bone metastases remain common. More effective treatment options are clearly needed.
authors.affiliation: Division of Medical Oncology, The Ottawa Hospital Cancer Centre & Department of Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Kuchuk
authors.affiliation: Ottawa Hospital Research Institute, Ottawa University, Department of Epidemiology and Community Medicine, Ottawa, Canada.
authors.forename: B
authors.initials: B
authors.lastname: Hutton
authors.affiliation: Division of Medical Oncology, The Ottawa Hospital Cancer Centre & Department of Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Moretto
authors.affiliation: Division of Internal Medicine, Department of Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Ng
authors.affiliation: Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada.
authors.forename: C L
authors.initials: CL
authors.lastname: Addison
authors.affiliation: Division of Medical Oncology, The Ottawa Hospital Cancer Centre & Department of Medicine, University of Ottawa, Ottawa, Canada; Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Clemons
keywords: Bone metastases; Bone targeted agents; Breast cancer; Pain; Skeletal related events