Incidence of bone metastases and survival after a diagnosis of bone metastases in breast cancer patients

Cancer Epidemiol. 2014 Aug;38(4):427-34. doi: 10.1016/j.canep.2014.05.005. Epub 2014 Jun 10.


Background: Bone is the most common metastatic site associated with breast cancer. Using a database of women with breast cancer treated at Guy's Hospital, London 1976-2006 and followed until end 2010, we determined incidence of and survival after bone metastases.

Methods: We calculated cumulative incidence of bone metastases considering death without prior bone metastases as a competing risk. Risk of bone metastases was modelled through Cox-regression. Survival after bone metastases diagnosis was calculated using Kaplan-Meier methodology.

Results: Of the 7064 women, 589 (22%) developed bone metastases during 8.4 years (mean). Incidence of bone metastases was significantly higher in younger women, tumour size >5 cm, higher tumour grade, lobular carcinoma and ≥ four positive nodes, but was not affected by hormone receptor status. Median survival after bone metastases diagnosis was 2.3 years in women with bone-only metastases compared with <1 year in women with visceral and bone metastases. There was a trend for decreased survival for patients who developed visceral metastases early, and proportionately fewer patients in this group.

Interpretation: Incidence of bone metastases has decreased but bone metastases remain a highly relevant clinical problem due to the large number of patients being diagnosed with breast cancer.

Keywords: Bone metastases; Breast cancer; Incidence; Survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bone Neoplasms / epidemiology*
  • Bone Neoplasms / secondary*
  • Breast Neoplasms / pathology*
  • Carcinoma / secondary*
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Middle Aged
  • Proportional Hazards Models