Al-Muqbel Kusai M, Yaghan Rami J
Department of Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Nucl Med Commun. 2013 Jun;34(6):577-81. doi: 10.1097/MNM.0b013e328360d6d5.
The aim of the study was to test the value of routine baseline and follow-up bone scans in societies with a prevalence of high-risk breast cancer features.
The medical records of 261 Jordanian breast cancer patients were reviewed. Patients who had (a) breast cancer proven by pathology, (b) had undergone a baseline bone scan, and (c) had undergone follow-up bone scan(s) for at least 12 months were included in the study. The patients were divided into three groups. Group 1 included 171 patients who had negative bone scans; group 2 included 52 patients who had negative baseline bone scans but developed bone metastasis on follow-up; and group 3 included 38 patients who had bone metastasis at presentation.
Patients' ages ranged between 21 and 85 years with mean ± SD of 49.7 (± 11.3) years. About 55% of our patients were younger than 50 years. Clinicopathological stages were as follows: 14% of patients were in stage I, 42% were in stage II, 30% were in stage III, and 14% were in stage IV. A significant proportion of our patients have high-risk features. Fourteen percent of the patients already had bone metastasis at diagnosis and 20% developed bone metastasis on follow-up. Sixty percent of group 2 patients developed bone metastasis within 2 years after diagnosis and the rest (40%) developed bone metastasis 2 years after diagnosis (≤ 13 years).
Within the limitations of this retrospective study, in a country like Jordan with greater prevalence of high-risk breast cancer features, a routine baseline whole-body bone scan might be justifiable. Follow-up whole-body bone scans might result in better quality of life and lower skeletal-related morbidity. Further prospective work is suggested.
本研究旨在检验在具有高风险乳腺癌特征的人群中进行常规基线和随访骨扫描的价值。
回顾了261例约旦乳腺癌患者的病历。纳入研究的患者需满足以下条件：（a）经病理证实患有乳腺癌；（b）已进行基线骨扫描；（c）已进行至少12个月的随访骨扫描。患者被分为三组。第1组包括171例骨扫描阴性的患者；第2组包括52例基线骨扫描阴性但随访时发生骨转移的患者；第3组包括38例初诊时即有骨转移的患者。
患者年龄在21岁至85岁之间，平均年龄±标准差为49.7（±11.3）岁。约55%的患者年龄小于50岁。临床病理分期如下：14%的患者为I期，42%为II期，30%为III期，14%为IV期。相当一部分患者具有高风险特征。14%的患者在诊断时已有骨转移，20%的患者在随访时发生骨转移。第2组中60%的患者在诊断后2年内发生骨转移，其余（40%）在诊断后2年（≤13年）发生骨转移。
在这项回顾性研究的局限性内，在像约旦这样高风险乳腺癌特征更为普遍的国家，进行常规基线全身骨扫描可能是合理的。随访全身骨扫描可能会带来更好的生活质量和更低的骨相关发病率。建议开展进一步的前瞻性研究。
