Background: Inflammatory breast cancer (IBC) is a rare yet aggressive variant of breast cancer with a high recurrence rate. We hypothesized that patterns of metastasis differ between IBC and non-IBC. We focused on the patterns of bone metastasis throughout disease progression to determine statistical differences that can lead to clinically relevant outcomes. Our primary outcome of this study is to quantify and describe this difference with a view to applying the findings to clinically relevant outcomes for patients.
Subjects, materials, and methods: We retrospectively collected data of patients with nonmetastatic IBC (n = 299) and non-IBC (n = 3,436). Probabilities of future site-specific metastases were calculated. Spread patterns were visualized to quantify the most probable metastatic pathways of progression and to categorize spread pattern based on their propensity to subsequent dissemination of cancer.
Results: In patients with IBC, the probabilities of developing bone metastasis after chest wall, lung, or liver metastasis as the first site of progression were high: 28%, 21%, and 21%, respectively. For patients with non-IBC, the probability of developing bone metastasis was fairly consistent regardless of initial metastasis site.
Conclusion: Metastatic patterns of spread differ between patients with IBC and non-IBC. Selection of patients with IBC with known liver, chest wall, and/or lung metastasis would create a population in whom to investigate effective methods for preventing future bone metastasis.
Implications for practice: This study demonstrated that the patterns of metastasis leading to and following bone metastasis differ significantly between patients with inflammatory breast cancer (IBC) and those with non-IBC. Patients with IBC had a progression pattern that tended toward the development of bone metastasis if they had previously developed metastases in the liver, chest wall, and lung, rather than in other sites. Selection of patients with IBC with known liver, chest wall, and/or lung metastasis would create a population in whom to investigate effective methods for preventing future bone metastasis.
摘要
背景 炎性乳腺癌 (IBC) 是一种罕见的侵袭性乳腺癌，复发率高。我们假设，IBC 与和非 IBC 的转移模式不同。我们着重研究了疾病进展中的骨转移模式，进而确定可能导致临床相关结果的统计差异。这项研究的主要结果是量化并描述这种差异，以便将研究结果应用于患者的临床相关结果中。
受试者、材料和方法 本研究回顾性收集了非转移性 IBC (n = 299) 和非 IBC (n = 3 436) 患者的资料。对未来特定部位转移的概率进行了计算。扩散模式经可视化处理，可以量化疾病进展最可能的转移途径，并根据其肿瘤随后扩散的倾向对扩散模式进行了分类。
结果 在 IBC 患者中，在第一个进展部位为胸壁、肺部或肝脏转移后，发生骨转移的概率颇高:分别为 28%、21%、21%。对于非 IBC 患者，无论最初转移部位是哪里，发生骨转移的可能性相当一致。
结论。IBC 患者和非 IBC 患者的转移扩散模式不同。选择已知发生肝脏、胸壁和/或肺部转移的 IBC 患者作为研究群体，研究预防之后发生骨转移的有效方法。
实践意义:本研究表明，炎性乳腺癌 (IBC) 患者与非 IBC 患者骨转移的发生模式和之后的转移模式存在显著差异。如果 IBC 患者先前在肝脏、胸壁和肺部，而不是在其他部位发生转移，则其进展模式更有可能发展成为骨转移。选择已知发生肝脏、胸壁和/或肺部转移的 IBC 患者作为研究群体，研究预防之后发生骨转移的有效方法。
Keywords: Bone metastasis; Breast cancer; Inflammatory breast cancer; Markov chain model; Prediction model.
© AlphaMed Press 2019.