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Breast cancer with skeletal metastases at initial diagnosis: Distinctive clinical characteristics and favorable prognosis
Author(s) -
Sherry Michael M.,
Greco F. Anthony,
Johnson David H.,
Hainsworth John D.
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19860701)58:1<178::aid-cncr2820580130>3.0.co;2-t
Subject(s) - medicine , breast cancer , asymptomatic , radiation therapy , cancer , surgery , stage (stratigraphy) , spinal cord compression , chemotherapy , radiology , spinal cord , paleontology , psychiatry , biology
Fifteen patients with breast cancer who had skeletal metastases already present at the time the primary breast lesion was detected, were retrospectively identified. The majority were postmenopausal, estrogen receptor‐positive, and had large (often neglected) primary lesions. Eleven patients were asymptomatic with respect to their skeletal metastases, although bone scans and bone roentgenograms revealed multiple areas of involvement in all patients. The median survival from the time of diagnosis was 33 months (range, 1‐74 months); the 5‐year actuarial survival was 45%. Systemic therapy with hormones or chemotherapy was effective in producing subjective responses; radiotherapy to painful bony areas was also an effective palliative treatment. Median survival in this group of patients was significantly improved when compared to our breast cancer patients who had extraskeletal metastases at initial diagnosis (33 versus 9 months, respectively), and to previously reported series of breast cancer patients with metastases at initial diagnosis. Since patients with Stage IV breast cancer and metastases limited to the skeleton often have prolonged survival, complications from bone metastases ( e.g. pathologic fracture, epidural spinal cord compression) and other intercurrent illnesses should be managed aggressively. Cancer 58:178–182, 1986.