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乳腺癌单发骨转移的临床病理特征。

Clinicopathologic features of single bone metastasis in breast cancer.

机构信息

Department of General Surgery, The University of Health Sciences, Izmir Bozyaka Education and Training Hospital.

Department of Public Health, Ege University, Medical Faculty.

出版信息

Medicine (Baltimore). 2021 Jan 8;100(1):e24164. doi: 10.1097/MD.0000000000024164.

Abstract

The most common site for metastasis in patients with breast cancer is the bone. In this case series, we investigated patients whose surgical and medical treatment for primary breast cancer was conducted at our center and first disease recurrence was limited to only 1 bone.We analyzed 910 breast cancer patients, 863 had no metastasis and 47 cases had a single bone metastasis ≥ 6 months after their first diagnosis. Demographic, epidemiological, histopathological and intrinsic tumor subtype differences between the non-metastatic group and the group with solitary bone metastases and their statistical significance were examined. Among established breast cancer risk factors, we studied twenty-nine variables.Three variables (Type of tumor surgery, TNM Stage III tumors and mixed type (invasive ductalcarsinoma + invasive lobular carcinoma) histology) were significant in multivariate logistic regression analysis. Accordingly, the risk of developing single bone metastasis was approximately 15 times higher in patients who underwent mastectomy and 4.8 and 2.8 times higher in those with TNM Stage III tumors and with mixed type (invasive ductal carcinoma + invasive lobular carcinoma) histology, respectively.In conclusion, the risk of developing single bone metastasis is likely in non-metastatic patients with Stage III tumors and possibly in mixed type tumors. Knowing this risk, especially in patients with mixed type tumors, may be instrumental in taking measures with different adjuvant therapies in future studies. Among these, treatment modalities such as prolonged hormone therapy and addition of bisphosphonates to the adjuvant treatments of stage III and mixed breast cancer patients may be considered.

摘要

乳腺癌患者最常见的转移部位是骨骼。在本病例系列研究中,我们调查了在我院接受原发性乳腺癌手术和治疗且首次疾病复发仅局限于 1 个部位的患者。我们分析了 910 例乳腺癌患者,其中 863 例无转移,47 例在首次诊断后 6 个月以上出现单发骨转移。我们对无转移组和单发骨转移组在人口统计学、流行病学、组织病理学和内在肿瘤亚型方面的差异进行了分析,并检验了其统计学意义。在已确立的乳腺癌危险因素中,我们研究了 29 个变量。在多变量逻辑回归分析中,有 3 个变量(肿瘤手术类型、III 期 TNM 肿瘤和混合性(浸润性导管癌+浸润性小叶癌)组织学)具有统计学意义。因此,接受乳房切除术的患者发生单发骨转移的风险约为接受保乳术患者的 15 倍,III 期 TNM 肿瘤和混合性(浸润性导管癌+浸润性小叶癌)组织学患者的风险分别增加了 4.8 倍和 2.8 倍。总之,III 期肿瘤和可能为混合性肿瘤的非转移性患者可能会发生单发骨转移。了解这种风险,特别是在混合性肿瘤患者中,可能有助于在未来的研究中采取不同辅助治疗措施。其中,可能需要考虑将延长激素治疗和在 III 期和混合性乳腺癌患者的辅助治疗中添加双膦酸盐等治疗方式作为治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e9e/7793343/8262083dab24/medi-100-e24164-g001.jpg

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