Journal Mobile Options
Table of Contents
Vol. 71, No. 5-6, 2006
Issue release date: October 2007
Oncology 2006;71:374–381

Diagnosis, Management and Clinical Outcome of Bone Metastases in Breast Cancer Patients: Results from a Prospective, Multicenter Study

Cazzaniga M.E. · Dogliotti L. · Cascinu S. · Barni S. · Labianca R. · Chiara S. · Conte P.F. · Gasparini G. · Pasetto L. · Torri V.
aOncology Unit, Treviglio Hospital, Treviglio, bOncology Unit, Orbassano Hospital, Torino, cOncology Unit, University of Ancona, Ancona, dOncology Unit, Ospedali Riuniti, Bergamo, eOncology Unit, IST, Genova, fDepartment of Oncology and Hematology, University of Modena, Modena, gOncology Unit, S Filippo Neri Hospital, Roma, hOncology Unit, Padova Hospital, Padova, and iOncology Department, Mario Negri Institute, Milano, Italy

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Background: Little information is available about the management and clinical outcome of bone metastases (BM) in breast cancer patients. Methods: We prospectively studied 459 breast cancer patients with first diagnosis of BM for at least 2 years to collect information about diagnosis, management and clinical outcome. Results: Two hundred and forty-eight patients (54%) had only BM, 86 (18.7%) had concomitant nonskeletal BM and 125 (27.2%) had previous nonskeletal BM. At enrolment, skeletal-related events were present in 132 patients (28.8%). Cancer treatments consisted of hormones (227/459, 49.5%) or chemotherapy (192/459, 41.8%). Age (≤70) and nonskeletal BM are inversely correlated with the use of chemotherapy or endocrine treatment (p < 0.0001). Bisphosphonates were used in 67.5% of the cases, alone (62.3%) or combined with other drugs. After a median follow-up of 28 months (range 2–43), 272 patients developed new metastases (59.2%), progression occurred mainly in nonskeletal sites (107/459, 23.3%), except for BM patients, who progressed prevalently at bone (69/248, 27.8%). New skeletal-related events were observed in 122 patients (26.6%). The 2-year probability for disease progression control and survival was 0.19 (95% CI 0.15–0.24) and 0.64 (95% CI 0.58–0.69), respectively. The 2-year probability for death according to the presence of nonskeletal metastases and the time of appearance (previous or concomitant to BM) was 0.74 (95% CI 0.67–0.79) for BM, 0.38 (95% CI 0.25–0.51) for previous nonskeletal BM and 0.56 (95% CI 0.46–0.66) for concomitant nonskeletal BM (p < 0.0001). Conclusions: Clinical outcome is significantly different according to the metastatic sites.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Galasko CSB: The anatomy and pathways of skeletal metastases; in Weiss L, Gilbert AH (eds): Bone Metastases. Boston, GK Hall, 1981, pp 49–63.
  2. Tubiana-Hulin M: Incidence, prevalence and distribution of bone metastases. Bone 1991;12(suppl 1):9–10.

    External Resources

  3. Rubens RD, Coleman RE: Bone metastases; in Albertoff MD, Armitage JO, Lichter AS, et al. (eds): Clinical Oncology, New York, Churchill Livingstone, 1995, pp 643–665.
  4. Coleman RE, Rubens RD: The clinical course of bone metastases from breast cancer. Br J Cancer 1987;55:61–66.
  5. Hortobagyi GN, Theriault RL, Porter L, et al: Efficacy of pamidronate in reducing skeletal complications in patients with advanced breast cancer and lytic bone metastases. Protocol 19 Aredia Breast Cancer Study Group. N Engl J Med 1996;335:1785–1791.
  6. Paterson AHG, Powels TJ, Kanis JA, et al: Double blind controlled trial of clodronate in patients with bone metastases from breast cancer. J Clin Oncol 1993;11:59–65.
  7. Official Italian Census 2001. Rome, ISTAT, 2002.
  8. Dancey J, Zee B, Osoba D, et al: Quality of life scores: an independent prognostic variable in a general population of cancer patients receiving chemotherapy. Qual Life Res 1997;6:151–158.
  9. Satagopan JM, Ben-Porat L, Berwick M, Robson M, Kutler D, Auerbach AD: A note on competing risks in survival data analysis. Br J Cancer 2004;91:1229–1235.
  10. Coleman RE, Smith P, Rubens RD: Clinical course and prognostic factors following bone recurrence from breast cancer. Br J Cancer 1998;78:336–340.
  11. James JJ, Evans AJ, Pinder SE: Bone metastases from breast carcinoma: histopathological-radiological correlations and prognostic factors. Br J Cancer 2003;89:660–665.
  12. Early Breast Cancer Trialists’ Collaborative Group: Polychemotherapy for early breast cancer: an overview of the randomised trials. Lancet 1998;352:930–942.
  13. Koizumi M, Yoshimoto M, Kasumi F, et al: Comparison between solitary and multiple skeletal metastatic lesions of breast cancer patients. Ann Oncol 2003;14:1234–1240.
  14. Boxer DI, Todd CE, Fogelman I: Bone secondaries in breast cancer: the solitary metastasis. J Nucl Med 1989;30:1318–1320.
  15. American Society of Clinical Oncology: Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. J Clin Oncol 1996;14:671–679.

    External Resources

  16. Cazzaniga ME, Pronzato P, Leto S: Patterns of relapse and modalities of treatment of breast cancer: the ‘IRIS’ project, a multicentre observational study. Oncology 2004;66:260–268.
  17. Hillner BE, Ingle JN, Berenson JR: American Society of Clinical Oncology guideline on the role of bisphosphonates in breast cancer. J Clin Oncol 2000;18:1378–1391.
  18. Hortobagyi GN, Theriault RL, Lipton A: Long term prevention of skeletal complications of metastatic breast cancer with pamidronate. J Clin Oncol 1998;16:2038–2044.
  19. Theriault RL, Lipton A, Hortobagyi GN: Pamidronate reduces skeletal morbidity in women with advanced breast cancer and lytic bone lesions: a randomized placebo-controlled trial. J Clin Oncol 1999;17:846–854.
  20. Coleman RE: Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 2006;12:6243–6249.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50