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Clinical Characteristics and Outcome of Bone-Only Metastasis in Inflammatory and Noninflammatory Breast Cancers

  • Megumi Kai
    Affiliations
    Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX

    Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX
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  • Takahiro Kogawa
    Affiliations
    Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX

    Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX
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  • Diane D. Liu
    Affiliations
    Department of Biostatistics, The University Texas MD Anderson Cancer Center, Houston, TX
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  • Tamer M. Fouad
    Affiliations
    Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX

    Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX
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  • Kazuharu Kai
    Affiliations
    Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX

    Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX
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  • Naoki Niikura
    Affiliations
    Departments of Breast and Endocrine Surgery Tokai University School of Medicine, Kanagawa, Japan
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  • Limin Hsu
    Affiliations
    Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX

    Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX
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  • Jie S. Willey
    Affiliations
    Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX

    Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX
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  • Richard L. Theriault
    Affiliations
    Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX

    Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX
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  • Vicente Valero
    Affiliations
    Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX

    Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX
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  • Naoto T. Ueno
    Correspondence
    Address for correspondence: Naoto T. Ueno, MD, PhD, Department of Breast Medical Oncology, Unit 1354, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 Fax: 713-794-4385
    Affiliations
    Department of Breast Medical Oncology, The University Texas MD Anderson Cancer Center, Houston, TX

    Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University Texas MD Anderson Cancer Center, Houston, TX
    Search for articles by this author
Published:August 15, 2014DOI:https://doi.org/10.1016/j.clbc.2014.06.007

      Abstract

      Background

      Inflammatory breast cancer is a rare and aggressive presentation of breast cancer. Bone is a common metastatic site in breast cancer, and bone-only metastatic disease is clinically considered to have a better prognosis than visceral metastasis. However, bone-only metastasis in IBC (bone-only IBC) has not been compared with bone-only metastasis in non-IBC (bone-only non-IBC) in terms of clinical features and outcome. Because of the intrinsically aggressive nature of IBC, we hypothesized that bone-only IBC has a poorer prognosis than does bone-only non-IBC.

      Patients and Methods

      We retrospectively identified patients with stage III primary diagnosed breast cancer who, between January 1997 and December 2012, had a first recurrence located only in the bone. Among the 197 patients that we defined as a study cohort, 50 patients had IBC and 147 patients had non-IBC. Progression-free survival (PFS) and overall survival (OS) from the date of recurrence were estimated using the Kaplan–Meier method, and patient characteristic groups were compared using the log-rank test.

      Results

      OS did not differ significantly between the 2 groups (P = .2467), but a shorter PFS was seen in patients with bone-only IBC than in patients with bone-only non-IBC (P = .0357). Among patients with estrogen receptor (ER)-positive disease, a much shorter PFS was seen in bone-only IBC than in bone-only non-IBC (P = .0159).

      Conclusion

      Bone-only IBC has a poorer prognosis than does bone-only non-IBC, particularly in those with ER-positive tumors. We might need to consider more aggressive intervention (eg, chemotherapy) for IBC patients with ER-positive bone-only metastatic disease.

      Keywords

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