Pattern of skeletal metastases from breast cancer in an Asian population

Objectives: To evaluate the pattern of skeletal metastases from breast carcinoma in an Asian population. To study the radiological pattern and distribution of bone metastases from breast cancer .
Background: Breast cancer is a disease that is prevalent world wide and frequently metastasis to the bones . Bone metastasis is associated with increase morbidity and poor quality of life in breast cancer patients. Prompt identification and treatment is the best way of improving the patients’ quality of life. Skeletal x-rays and bones scan of relevant bones should be part of staging investigations and metastatic survey in breast cancer.
Methods: This study was prospective, non-randomized, and single institution based. A total of 30 consecutive patients having bone pains with radiological evidence of bone metastases were included. Questionnaire was designed for the collection of patients’ data for evaluation, which was then entered on database and analyzed on the Statistical Package for Social Sciences (SPSS). Patient were staged using TNM Classification.
Results: The radiological pattern was Osteolytic in (28) 93.3% and mixed pattern (osteolytic & osteoblastic) in (2)6.7%. The commonest site of bone metastases was Lumbar spine (51.5%) followed by the Thoracic spine (21.6%). There was involvement of multiple, non-contiguous skeletal bones in(7)23.3% of the patients. Majority of the patients were stage III (56.6%) at first presentation. At presentation (6) 20% had painful bone metastases and 16.7% developed painful bone metastases within 12 months, 30.0% from 12 to 24 months, and 33.3% after 24 months of diagnosing breast cancer. 20.0% of patients had painful bone metastases for ≤ 3 months prior to local field irradiation (LFI); 46.7% had pain for 4 – 6 months; 6.7% had pain for 7 – 9 months; 10.0% had pain for 10 – 12 months; and 16.7% had pain for more than 12 months prior to treatment with LFI.
Conclusion: The predominant x-ray finding in bone metastases from breast cancer was osteolytic and the Lumbar spine was the commonest site of involvement . Involvement of Multiple bones in 25% of the patients suggest widespread search in a staging protocol.