Hilal Yağar1, Mahmut Nedim Aytekin2, Didem Şener Dede3, Mehmet Ali Nahit Şendur3, Recep Öztürk4, Bülent Yalçın3

1Department of Orthopedics and Traumatology, Ömer Halisdemir University, Niğde, Türkiye
2Department of Orthopedics and Traumatology, Yüksek Ihtisas University, Ankara, Türkiye
3Department of Medical Oncology, Yıldırım Beyazıt University, Ankara, Türkiye
4Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

Keywords: Bone metastasis, breast cancer, metastatic volume, skeletal related event.


Objectives: The study aimed to investigate the relationship between metastatic volume measurement, skeletal-related events, and survival in women diagnosed with breast cancer and bone metastases.

Patients and methods: This retrospective study was conducted with 82 female breast cancer patients (mean age: 53±14.3 years; range, 23 to 87 years) diagnosed, treated, and followed up between January 2005 and December 2019. The collected data included information on metastasis sites and the presence of skeletal-related events. Metastatic volume was measured in two ways: the number of metastases (high to low) and their localization (the first, second, and third groups). The first group consisted of vertebrae, ribs, sternum, and calvarial bones; the second group included scapula, clavicle, proximal humerus, and proximal femur regions; the third group consisted of femur and humerus diaphyseal and distal regions, as well as metastasis regions in other long bones.

Results: Sixty-three (76.8%) patients were diagnosed with ductal carcinoma. Half of the patients had bone metastases at the time of initial diagnosis, while 62 (75.6%) experienced skeletal-related events, with at least three events occurring in 30 (36.6%) patients. Bone pain was the most common skeletal-related event. No correlation was found between metastatic volume measurement based on the localization of bone metastases and the number of bones and the occurrence of skeletal-related events (p>0.05 for each). Patients’ survival time spanned from one to 231 months (median: 56.8 months) from their first diagnosis. Patients with high metastatic volume, those in the third group, those whose pelvis and lung were involved, and elderly patients had a shorter survival time (p<0.05 for each).

Conclusion: The study indicates that measuring metastatic volume may be a critical factor in evaluating the survival of breast cancer patients with bone metastases. Future prospective and randomized controlled studies can explore the potential of this measurement to create practical clinical tools.

Citation: Yağar H, Aytekin MN, Şener Dede D, Şendur M.A.N., Öztürk R, Yalçın B. Do metastatic volumes measured in breast cancer patients with bone metastases correlate with the numbers of skeletal and extraskeletal events? Jt Dis Relat Surg 2024;35(1):105-111. doi: 10.52312/jdrs.2023.1333.

Ethics Committee Approval

The study protocol was approved by the Yıldırım Beyazıt University Faculty of Medicine Clinical Research Ethics Committee (date: 09.05.2019, no: 63). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Data collection and/or processing, writing the article, literature review, references: H.Y.; Idea/ concept, data collection and/or processing: M.N.A.; Analysis and/or interpretation, critical review: D.Ş.D.; Design: M.A.N.Ş.; Critical review: R.Ö.; Idea/concept, design: B.Y. All authors approved the final version of this manuscript.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.