Sobrevida de pacientes con cáncer de mama y metástasis ósea / Survival of patients with breast cancer and bone metastasis

Introduction: Breast cancer is an important cause of death among female cancer in Chile. It metastasizes to any part of the body, being bone the first area of dissemination in 26-50 percent of cases and being found in 75 percent of patients dead from this cause. A median survival of 18 to 24 months is reported, and a probability of surviving 5 years of 20 percent. Therefore the objective of this study is to determine the difference of median survival depending on the presence of bone metastasis. Methods: A retrospective cohort study was conducted with 822 patients diagnosed with breast cancer between 2003 and 2010. The exposed cohort had scintigraphicly diagnosed bone metastasis, and the control group had no bone metastasis. Results: 8.88 percent of 822 patients, had bone metastasis. Those with bone metastasis had a mortality of 74 percent, and in the group with no bone metastasis, 16.69 percent died (p < 0.01). The median survival of patients with no metastasis was 44.3 months (IQR 35-83), and with metastasis was of 35 (IQR 18.6-46.1) (p < 0.01). With bone metastasis, over 48 months survival was 30.6 percent; and over 84 months 14.8 percent. Without bone metastasis, above 84 months, 78.51 percent survived (p < 0.01). Discussion and Conclusions: The difference between the two groups, considering global survival, is significant and implies an important decrease in survival and quality of life; the result obtained also differs from those reported in literature and it makes us reflect on the importance to consider bone metastasis not as a terminal event...

Introducción: El cáncer de mama es una importante causa de muerte por cáncer en las mujeres chilenas. Metastatiza a cualquier parte del cuerpo, siendo hueso la primera zona de diseminación en 26-50 por ciento de los casos, encontrándose un 75 por ciento de los pacientes que fallecen por esta causa. Se reporta una sobrevida de 18-24 meses, y una supervivencia a los 5 años del 20 por ciento. El objetivo del siguiente trabajo es determinar la sobrevida ante presencia de metástasis óseas. Pacientes y Método: Se realizó un estudio de cohortes retrospectivas con 822 pacientes diagnosticadas con cáncer de mama entre los años 2003 y 2010. La cohorte expuesta tiene diagnóstico cintigráfico de metástasis ósea, y la de control no tiene metástasis óseas. Resultados: 8,88 por ciento del total de 822 pacientes, presentó metástasis ósea. Con metástasis ósea existió una mortalidad del 74 por ciento, mientras que sin metástasis fue 16,69 por ciento (p < 0,01). La mediana de sobrevida sin metástasis ósea fue 44,3 meses (RIQ 35-83), en cambio, ante metástasis ósea fue 35 meses (RIQ 18,6-46,1) (p < 0,01). A los 48 meses, la supervivencia fue del 30,6 por ciento, para los pacientes con metástasis ósea y a los 84 meses, 14,8 por ciento, mientras que en los pacientes sin metástasis, la sobrevida a los 84 meses fue de 78,51 por ciento (p < 0,01). Discusión y Conclusiones: La diferencia de sobrevida entre pacientes con y sin metástasis ósea es significativa, implica una disminución en la supervivencia y la calidad de vida; difiere poco de lo reportado en la literatura, pero no debe hacernos considerar la metástasis ósea como un evento terminal de la enfermedad...

Male breast cancer in Tripoli, Libya

To study the epidemiology, characteristics, and survival of male breast cancer patients. This non-randomized retrospective study includes male patients with breast cancer confirmed by biopsy. A total of 1568 breast cancer patients were registered in the Oncology Department, Tripoli Medical Center, Tripoli, Libya between January 1990 to June 2008. Twenty-two patients were male [1.4%]. The mean age of male breast cancer patients was 61 years. They tend to have advanced local disease, as 65% of them were tumor [T]3 and T4, and 93.3% have positive lymph nodes. The preferred surgical treatment was mastectomy and axillary clearance in 65%, and 85% had invasive duct carcinoma. Regarding hormone receptor status, 70% were estrogen and progesterone positive. A total of 71% received chemotherapy as anthracycline based. During follow up, the overall recurrence rate was 47%. The bone was the most common site of relapse [37.5%]. Overall survival rate was 82.4% at first, 76.5% at second, and 57% at fifth year. Two patients were brothers, and one of them developed multiple myeloma during follow up. In comparison to female patients with breast cancer, male patients are older, and have more advanced and more hormone positive disease

Clinicopathological Characteristics of Male Breast Cancer

PURPOSE: To investigate clinicopathological characteristics and outcomes of male breast cancer (MBC). PATIENTS AND METHODS: We retrospectively analyzed the data of 20 MBC patients in comparison with female ductal carcinoma treated at Yonsei University Severance Hospital from July 1985 to May 2007. Clinicopathological features, treatment patterns, and survival were investigated. RESULTS: MBC consists of 0.38% of all breast cancers. The median age was 56 years. The median symptom duration was 10 months. The median tumor size was 1.7cm, 27.8% showed node metastasis, and 71.4% were estrogen receptor positive. All 20 cancers were arisen from ductal cells. No lobular carcinoma was found. The incidence of stages 0, I, II, and III in patients were 2, 10, 4, and 3, respectively. All patients underwent mastectomy. One with invasive cancer did not receive axillary node dissection and stage was not exactly evaluated. Adjuvant treatments were determined by pathologic parameters and stage. Clinicopathological parameters and survival rates of MBC were comparable to those of female ductal carcinoma. CONCLUSION: The onset age of MBC was 10 years older and symptom duration was longer than in female patients. No difference in outcomes between MBC and female ductal carcinoma suggests that the biology of MBC is not different from that of females. Therefore, education, an appropriate system for early detection, and adequate treatment are necessary for improving outcomes.