Abstract
BackgroundBreast cancer is the most common malignancy in women, and it is also the leading cause of death in female patients; the most common pathological type of BC is infiltrating duct carcinoma (IDC). Some nomograms have been developed to predict bone metastasis (BM) in patients with breast cancer. However, there are no studies on diagnostic and prognostic nomograms for BM in newly diagnosed IDC patients.MethodsIDC patients with newly diagnosed BM from 2010 to 2016 in the Surveillance, Epidemiology and End Results (SEER) database were reviewed. Multivariate logistic regression analysis was used to identify risk factors for BM in patients with IDC. Univariate and multivariate Cox proportional hazards regression analysis were used to explore the prognostic factors of BM in patients with IDC. We then constructed nomograms to predict the risk and prognosis of BM for patients with IDC. The results were validated using bootstrap resampling and retrospective research on 113 IDC patients with BM from 2015 to 2018 at the Affiliated Hospital of Chengde Medical University.ResultsThis study included 141,959 patients diagnosed with IDC in the SEER database, of whom 2383 cases were IDC patients with BM. The risk factors for BM in patients with IDC included sex, primary site, grade, T stage, N stage, liver metastasis, race, brain metastasis, breast cancer subtype, lung metastasis, insurance status, and marital status. The independent prognostic factors were brain metastases, race, grade, surgery, chemotherapy, age, liver metastases, breast cancer subtype, insurance status, and marital status. Through calibration, receiver operating characteristic curve and decision curve analyses, we found that the nomogram for predicting the prognosis of IDC patients with BM displayed great performance both internally and externally.ConclusionThese nomograms are expected to be a precise and personalized tool for predicting the risk and prognosis for BM in patients with IDC. This will help clinicians develop more rational and effective treatment strategies.
Highlights
Breast cancer is the most common malignancy in women, and it is the leading cause of death in female patients; the most common pathological type of BC is infiltrating duct carcinoma (IDC)
Baseline characteristics of the study population Based on our criteria, a total of 141,959 IDC patients from the SEER database were included, and an additional 113 IDC patients with bone metastasis (BM) were identified from the Affiliated Hospital of Chengde Medical University (AHOCMU) for this study
1671 patients were included in the training cohort and 712 patients were included in the validation cohort
Summary
Breast cancer is the most common malignancy in women, and it is the leading cause of death in female patients; the most common pathological type of BC is infiltrating duct carcinoma (IDC). Some nomograms have been developed to predict bone metastasis (BM) in patients with breast cancer. There are no studies on diagnostic and prognostic nomograms for BM in newly diagnosed IDC patients. Breast cancer (BC) is the most common malignancy and the leading cause of death among all female cancer patients [1, 2]. With the advancement of early diagnosis and comprehensive treatment, the mortality rate of BC has gradually decreased, and distant metastasis has become the main cause of death for these patients [4, 5]. Bone metastasis (BM) accounts for 50% of all distant metastases in these patient [7]. Some studies have shown that the median survival for patients with breast cancer and BM is only 24– 36 months [10]
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