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Annals of Oncology
372P INCIDENCE OF BONE METASTASES AND SURVIVAL AFTER A
DIAGNOSIS OF BONE METASTASES (BM) IN BREAST
CANCER PATIENTS
L. Holmberg 1 , M. Harries 2 , O. Agbaje 1 , H. Garmo 3 , S. Kabilan 3 , A. Taylor 4 ,
A. Purushotham 5
1 Division of Cancer Studies, Cancer Epidemiology Unit, Research Oncology,
Kings College London School of Medicine, Guys Hospital, London, UNITED
KINGDOM, 2 Department of Medical Oncology, Guys and St Thomas’s Hospitals
NHS Foundation Trust, Guys Hospital, London, UNITED KINGDOM, 3 Division of
Cancer Studies, Cancer Epidemiology Unit, Research Oncology, King’s College
London School of Medicine, Guys Hospital, London, UNITED KINGDOM,
4 Centre for Observational Research (Oncology), Amgen Ltd., Uxbridge, UNITED
KINGDOM, 5 Division of Cancer Studies, Research Oncology, Kings College
London School of Medicine, Guys Hospital, London, UNITED KINGDOM
Objectives: To measure crude and cumulative incidence of BM and cumulative
survival after diagnosis of BM. BM were grouped by (i) BM only (ii) BM followed by
visceral metastases (iii) visceral metastases followed by BM.
Methods: Kaplan-Meier and Cox regression database analysis of women with breast
cancer diagnosed 1975-2006 and treated at Guys Hospital London, whose details
were prospectively updated regularly till end 2010.
Results: Of 7064 women, 1589 (22%) developed BM by end follow-up (mean 8.4
years); 2254 (32%) were diagnosed with breast cancer < 50 years, and 4810 (68%)
≥50 years; 735 (14.4%) were classified as grade I, 2303 (45.3%) grade II and 2049
(40.3%) grade III; 1530 (27.8%) were estrogen receptor (ER) –ve and 3982 (72.2%)
ER +ve. Of all BM, 535 (33.7%) patients were in group i; 871 (54.8%) in group ii and
183 (11.5%) in group iii. Incidence of all BM within 0-3 years from breast cancer
diagnosis was highest in 1980 (64/1000 person years) and lowest in 2006 (11/1000
person years), with the decline most pronounced in 1985-1990. Cumulative incidence
of BM after 5 years follow up was highest in 1976-1982 (0.25 [95% CI 0.23-0.27]),
falling to 0.22 (0.20-0.24) in 1983-1989, 0.18 (0.10-0.14) in 1990-1997 and 0.095
(0.08-0.12) in 1998-2006.Risk of BM was significantly influenced by: calendar period
of breast cancer diagnosis, HR was 0.77 (0.68-0.86) 1983-1989, 0.46 (0.40-0.54)
1990-1997 and 0.33 (0.28-0.40) 1998-2006, all vs 1975-1982; tumour grade, HR 1.23
(1.08 - 1.40) grade 3 vs 1-2; nodal status, HR 1.88 (1.60-2.21) 1-3 nodes vs 0 nodes
and 3.95 (3.36-4.64) 4+ nodes vs 0 nodes; and tumour size, HR 2.00 (1.75-2.29) 2-5
cm vs