Abstract
BackgroundBone Scan Index (BSI) expresses tumor burden in bone as a percentage of total skeletal mass, but its significance for metastatic breast cancer patients is unknown. We investigated whether baseline BSI is associated with skeletal-related events (SREs) or survival and identified the cut-off BSI score for predicting SREs in metastatic breast cancer patients.MethodsWe retrospectively reviewed 144 patients with bone metastatic breast cancer. Bone scan examinations were performed and BSI was calculated using the Bonenavi® automated method. All patients received standard medical treatment for metastatic breast cancer. For bone metastasis prophylaxis, bisphosphonates were infused initially with analgesics as needed. We defined SRE as either bony, requiring intervention (surgery and/or radiotherapy) for pain or prevention of fracture, or spinal cord compression. The rates of SRE and overall survival (OS) were evaluated according to baseline BSI, and the cut-off score of BSI for predicting SRE in metastatic breast cancer patients was identified.ResultsThirty-three patients (25.6 %) had SREs. The median BSI was 1.08 % (inter-quartile range 0.50–3.23 %). To identify the cut-off BSI score for predicting SRE, we performed sensitivity analysis to check P-value at every 0.1 BSI interval (0.4–2.4) by multiple-variable proportional hazard analysis. A BSI cut-off point of 1.4 % showed the lowest P value. Patients with BSI scores ≥1.4 had a significantly higher rate of SRE than those with lower BSI (P = 0.022). However there was no significant difference in OS.ConclusionBSI may predict SRE in patients with metastatic breast cancer. A high BSI value (≥1.4) at diagnosis of bone metastasis may be a predictor of SREs in bone metastatic breast cancer patients.
Highlights
Bone Scan Index (BSI) expresses tumor burden in bone as a percentage of total skeletal mass, but its significance for metastatic breast cancer patients is unknown
Idota et al SpringerPlus (2016) 5:1095 to detect skeletal metastasis despite advances in other modalities such as PET-CT and MRI, routinely examination is not always recommended in breast cancer patients. It can help diagnose a number of conditions relating to bones, including cancer of the bone or cancers that have metastasized to bone, its findings are frequently non-specific because the uptake of 99mTc-methyl diphosphonate depends on the integrity of osteoblasts and on matrix activity
The purpose of this study was to evaluate the rate of skeletal-related events (SREs) and overall survival (OS) according to the baseline BSI, and to identify the cut-off score of BSI for predicting SRE in metastatic breast cancer patients
Summary
Bone Scan Index (BSI) expresses tumor burden in bone as a percentage of total skeletal mass, but its significance for metastatic breast cancer patients is unknown. Idota et al SpringerPlus (2016) 5:1095 to detect skeletal metastasis despite advances in other modalities such as PET-CT and MRI, routinely examination is not always recommended in breast cancer patients. It can help diagnose a number of conditions relating to bones, including cancer of the bone or cancers that have metastasized to bone, its findings are frequently non-specific because the uptake of 99mTc-methyl diphosphonate depends on the integrity of osteoblasts and on matrix activity. Lytic lesions are underestimated by bone scan and less well visualized by Bone Scan Index (BSI), which is less the case for cancer of the prostate, where the lesions are almost all sclerotic with a scintigraphy hot spot appearance. In addition an appropriate approach for quantitative analysis is required
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