Gao Tianyuan, Shao Fang
Department of Pathology, Second Affiliated Hospital of Wannan Medical College, Anhui Wuhu, China.
Department of Breast Surgery, 162737Changzhou No. 4 People's Hospital, Soochow University, Changzhou, China.
J Orthop Surg (Hong Kong). 2021 May-Aug;29(2):23094990211000144. doi: 10.1177/23094990211000144.
Inflammatory breast cancer (IBC) is a rare type of breast cancer with poor prognosis. IBC patients with bone metastasis (BM) often suffer from many complications. This study was performed to identify risk factors with strong capability of predicting high BM risk for IBC patients and find prognostic factors for those patients.
The Surveillance, Epidemiology and End Results (SEER) database was used to collect the clinicopathological and survival information of IBC patients. 966 IBC patients diagnosed between 2010 and 2015 were included to study the risk factors for developing BM by using Multivariable logistic regression. A total of 194 and 176 patients were included to analyze independent prognostic factors for overall survival (OS) and cancer specific survival (CSS) of IBC patients with BM respectively.
Of the 966 IBC patients, 194 (20.1%) patients were with BM. The risk factors for developing BM in IBC patients included unmarried marital status, double breast tumor, N1 stage, N3 stage, and liver metastases had higher risk of BM, while those of uninsured status and triple negative breast cancer (TNBC) were less likely to have BM. Analysis of prognostic factors for OS and CSS of IBC patients with BM showed that TNBC subtype and liver metastases were independently significantly associated with poorer OS and CSS of BM patients, while chemotherapy could serve as an independent prognostic factor for better OS and CSS of BM patients.
Marital status, double breast tumor, N1 stage, N3 stage, and liver metastases should be considered for prediction of BM in IBC patients. TNBC subtype and liver metastases may indicate poor survival and chemotherapy can indicate improved survival for IBC patients with BM.
炎性乳腺癌（IBC）是一种预后较差的罕见乳腺癌类型。发生骨转移（BM）的IBC患者常伴有多种并发症。本研究旨在确定对IBC患者发生高BM风险具有强大预测能力的危险因素，并找出这些患者的预后因素。
利用监测、流行病学和最终结果（SEER）数据库收集IBC患者的临床病理和生存信息。纳入2010年至2015年间诊断的966例IBC患者，采用多变量逻辑回归研究发生BM的危险因素。分别纳入194例和176例患者，分析发生BM的IBC患者总生存（OS）和癌症特异性生存（CSS）的独立预后因素。
966例IBC患者中，194例（20.1%）发生BM。IBC患者发生BM的危险因素包括未婚、双侧乳腺肿瘤、N1期、N3期，肝转移发生BM的风险更高，而未参保状态和三阴性乳腺癌（TNBC）发生BM的可能性较小。对发生BM的IBC患者的OS和CSS预后因素分析表明，TNBC亚型和肝转移与BM患者较差的OS和CSS独立显著相关，而化疗可作为BM患者OS和CSS较好的独立预后因素。
在预测IBC患者发生BM时应考虑婚姻状况、双侧乳腺肿瘤、N1期、N3期和肝转移。TNBC亚型和肝转移可能提示生存较差，化疗可提示发生BM的IBC患者生存改善。
