[MOL] To Help Determine Breast Cancer Metastases... [00040] Medicine On Line

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[MOL] To Help Determine Breast Cancer Metastases...

MILAN-An international study has identified diagnostic signs to help
spot breast-cancer patients at high risk for bone metastases who
might qualify for therapy with bisphosphonates.
A review of records of 6,792 breast-cancer patients in seven
clinical trials of adjuvant therapy in nine nations, with a median
follow-up of 10.7 years, found that women with four or more positive
nodes at diagnosis were at the highest risk of developing bone
metastases. The 1,220 patients who had a local, regional, or soft-
tissue first recurrence were also at the top of the list.
Some 14.9% of the 2,163 women with four or more four positive nodes
developed bone metastases within two years of randomization, compared
with an overall rate of 8.2% at two years. Within 10 years, 40.8% had
developed bone metastases, compared with 27.3% at 10 years for the
entire cohort, Milan’s Dr. Marco Colleoni and colleagues in the
International (Ludwig) Breast Cancer Study Group reported in the
Dec. 1 Journal of Clinical Oncology.
In women whose initial recurrence was local, regional, or in soft
tissue, who had a median follow-up of 7.7 years after recurrence,
bone metastases were found in 21.1% within two years of the
recurrence and in 36.7% after 10 years, according to the group. The
investigators came from five European nations, South Africa,
Australia, and New Zealand, and from the Dana-Farber Cancer Institute
in Boston.
Women younger than 35, patients with tumors larger than 2 cm, and
those with ER-positive tumors were also at an increased risk. At 10
years, 36.3% of women younger than 35 had developed bone metastases,
vs. 27.6% of older women.
And 32.0% of women with tumors larger than 2 cm developed bone
metastases, vs. 21.2% of women with tumors under 2 cm. So did 28.7%
of women with ER-positive tumors, vs. 22.3% of women with ER-negative
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