Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Oncologist. 2019 Oct;24(10):1322-1330. doi: 10.1634/theoncologist.2018-0713. Epub 2019 Apr 5.
Inflammatory breast cancer (IBC) is a rare yet aggressive variant of breast cancer with a high recurrence rate. We hypothesized that patterns of metastasis differ between IBC and non-IBC. We focused on the patterns of bone metastasis throughout disease progression to determine statistical differences that can lead to clinically relevant outcomes. Our primary outcome of this study is to quantify and describe this difference with a view to applying the findings to clinically relevant outcomes for patients.
SUBJECTS, MATERIALS, AND METHODS: We retrospectively collected data of patients with nonmetastatic IBC ( = 299) and non-IBC ( = 3,436). Probabilities of future site-specific metastases were calculated. Spread patterns were visualized to quantify the most probable metastatic pathways of progression and to categorize spread pattern based on their propensity to subsequent dissemination of cancer.
In patients with IBC, the probabilities of developing bone metastasis after chest wall, lung, or liver metastasis as the first site of progression were high: 28%, 21%, and 21%, respectively. For patients with non-IBC, the probability of developing bone metastasis was fairly consistent regardless of initial metastasis site.
Metastatic patterns of spread differ between patients with IBC and non-IBC. Selection of patients with IBC with known liver, chest wall, and/or lung metastasis would create a population in whom to investigate effective methods for preventing future bone metastasis.
This study demonstrated that the patterns of metastasis leading to and following bone metastasis differ significantly between patients with inflammatory breast cancer (IBC) and those with non-IBC. Patients with IBC had a progression pattern that tended toward the development of bone metastasis if they had previously developed metastases in the liver, chest wall, and lung, rather than in other sites. Selection of patients with IBC with known liver, chest wall, and/or lung metastasis would create a population in whom to investigate effective methods for preventing future bone metastasis.
炎性乳腺癌（IBC）是一种罕见但侵袭性很强的乳腺癌变体，复发率很高。我们假设 IBC 和非 IBC 之间的转移模式不同。我们专注于疾病进展过程中的骨转移模式，以确定可以导致临床相关结果的统计差异。本研究的主要结果是量化和描述这种差异，以期将这些发现应用于患者的临床相关结果。
受试者、材料和方法：我们回顾性收集了非转移性 IBC（n=299）和非 IBC（n=3436）患者的数据。计算了未来特定部位转移的概率。可视化传播模式以量化最可能的进展转移途径，并根据随后癌症传播的倾向对传播模式进行分类。
在 IBC 患者中，作为第一进展部位的胸壁、肺或肝转移后发生骨转移的概率较高：分别为 28%、21%和 21%。对于非 IBC 患者，无论初始转移部位如何，发生骨转移的概率都相当一致。
IBC 和非 IBC 患者的转移扩散模式不同。选择已知有肝、胸壁和/或肺转移的 IBC 患者，可以为研究预防未来骨转移的有效方法创造一个人群。
本研究表明，导致和随后发生骨转移的转移模式在 IBC 患者和非 IBC 患者之间有显著差异。如果 IBC 患者先前已在肝脏、胸壁和/或肺部发生转移，而不是在其他部位，则其进展模式倾向于发生骨转移。选择已知有肝、胸壁和/或肺转移的 IBC 患者，可以为研究预防未来骨转移的有效方法创造一个人群。
