KMID : 0939920110430020089
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´ëÇѾÏÇÐȸÁö 2011 Volume.43 No. 2 p.89 ~ p.95
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Implications of Bone-Only Metastases in Breast Cancer: Favorable Preference with Excellent Outcomes of Hormone Receptor Positive Breast Cancer
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Lee Su-Jin
Park Silvia Ahn Hee-Kyung Yi Jun-Ho Cho Eun-Yoon Sun Jong-Mu Lee Jeong-Eon Nam Seok-Jin Yang Jung-Hyun Park Yeon-Hee Ahn Jin-Seok Im Young-Hyuck
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Abstract
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Purpose: The aim of the current study was to determine the incidence, clinical presentation, and treatment outcomes of "bone-only metastases" in patients with breast cancer and to analyze the impact of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status on prognosis.
Materials and Methods: Between 1994 and 2007, of 968 patients with metastatic breast cancer who underwent palliative management at Samsung Medical Center, 565 (57%) relapsed with distant metastases. Of the 968, 146 (15%) had bone-only metastases during a median follow-up period of 75 months. Among the 146 patients with bone-only metastases, 122 (84%) were relapsed patients after curative surgery and 24 (26%) were initially metastatic cases.
Results: The median time from primary surgery to bone-only metastases of the 122 patients was 37 months (95% confidence interval [CI], 27 to 46 months). Bone-only metastases were more common in the HR-positive group than in the other subtypes (85% for HR+; 8.2% for HER2+; 6.8% for triple negative. Among all 146 patients, 75 (51%) were treated with hormone therapy. The median post-relapse progression-free survival was 15 months (95%CI, 13 to 17 months). The median overall survival was much longer in the HR+ patients than the HER2+ and triple negative breast cancer patients with marginal statistical significance (65 vs. 40 vs. 40 months, p=0.077).
Conclusion: Breast cancer patients with "bone-only metastases" had excellent clinical outcomes. Further study is now warranted to reveal the underlying biology that regulates the behavior of this indolent tumor, as it should identify ¡¯favorable tumor characteristics¡¯ in addition to ¡¯favorable preferential metastatic site.¡¯
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KEYWORD
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Bone, Neoplasm metastasis, Breast neoplasms, Estrogen receptors, Progesterone receptors, HER2
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