Prognostic factors for patients with bone-only metastasis in breast cancer

Yonsei Med J. 2013 Sep;54(5):1168-77. doi: 10.3349/ymj.2013.54.5.1168.


Purpose: Bone is the most frequent site of metastasis among breast cancer patients. We investigated prognostic factors affecting survival following bone-only metastasis in breast cancer patients.

Materials and methods: The medical records of breast cancer patients who were treated and followed at Gangnam Severance Hospital retrospectively reviewed to identify patients with bone-only metastasis.

Results: The median time from the diagnosis of bone-only metastasis to the last follow-up or death was 55.2 [95% confidence interval (CI), 38.6-71.9] months. The Kaplan-Meier overall survival estimate at 10 years for all patients was 34.9%. In the multivariate Cox regression model, bisphosphonate treatment [hazard ratio=0.18; 95% CI, 0.07-0.43], estrogen receptor positivity (hazard ratio=0.51; 95% CI, 0.28-0.94), and solitary bone metastasis (hazard ratio=0.32; 95% CI, 0.14-0.72) were significantly associated with longer overall survival in the bone-only recurrence group. Among the treatment modalities, only bisphosphonate treatment was identified as a significant prognostic factor.

Conclusion: Identifying the factors influencing breast cancer mortality after bone-only metastasis will help clarify the clinical course and improve the treatment outcome for patients with breast cancer and bone-only metastasis. Bisphosphonates, as a significant prognostic factor, warrant further investigation.

Keywords: Breast neoplasm; bisphosphonate; bone metastses.

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / genetics
  • Bone Neoplasms / secondary*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / genetics
  • Breast Neoplasms / pathology*
  • Female
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Receptors, Estrogen / genetics
  • Receptors, Progesterone / genetics
  • Regression Analysis
  • Retrospective Studies
  • Survival Analysis


  • Antineoplastic Agents
  • Receptors, Estrogen
  • Receptors, Progesterone