Similar Prognosis of Patients with Bone-only Metastatic Breast Cancer and Visceral Metastasis

Main Article Content

Ryutaro Mori
Manabu Futamura
Yoshimi Asano
Akira Nakakami
Kazuhiro Yoshida


Secondary breast neoplasms, bone metastasis, prognosis


Background: Bone-only metastatic breast cancer is believed to be non-life-threatening, and mild therapy is frequently selected to avoid adverse events of drug therapy. However, the prognoses of such patients are not well studied.
Methods: Patients who received drug therapies for metastatic breast cancer between 2004 and 2016 at our institution were divided into the “Bone-only metastasis”, “non-visceral”, and “visceral” groups based on the mode of the first metastasis, and the efficacy of the first-line therapy and survival of these patients were compared.
Results: There were 131 eligible patients, and the bone-only metastasis, non-visceral, and visceral groups included 26, 25, and 80 patients, respectively. The median survival time (MST) of the overall survival (OS) in each group was 35.1, 34.9, and 37.4 months, respectively (p=0.71). The clinical benefit rates of first-line therapy in the bone-only metastasis, non-visceral, and visceral groups were 66.7%, 45%, and 69.3%, respectively, and the MST of the time to treatment failure (TTF) in each group was 6.3, 5.5, and 5.8 months, respectively, showing that the efficacy of first-line therapy did not significantly differ among the groups. In the bone-only metastasis group, patients with <5 metastases tended to have a good prognosis, and those with a low nuclear grade and long first-line therapy duration had a significantly better prognosis than others.
Conclusion: The patients with bone-only metastasis had a similar prognosis and treatment response to those with other modes of metastasis, and the patients with a good response to the first-line therapy had a good prognosis.


1. Greenberg PA, Hortobagyi GN, Smith TL, Ziegler LD, Frye DK, Buzdar AU. Long-term follow-up of patients with complete remission following combination chemotherapy for metastatic breast cancer. J Clin Oncol. 1996; 14:2197-205.
2. Chia SK, Speers CH, D'yachkova Y, Kang A, Malfair-Taylor S, Barnett J, et al. The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer. Cancer. 2007;110: 973-9.
3. Hortobagyi GN. Treatment of breast cancer. N Engl J Med. 1998;339:974-84
5. Swenerton KD, Legha SS, Smith T, Hortobagyi GN, Gehan EA, Yap HY, et al. Prognostic factors in metastatic breast cancer treated with combination chemotherapy. Cancer Res. 1979;39:1552-62.
6. Kuechle JB, McGrath BE, Khoury T, Mindell ER. A case of long term survival with skeletal only metastatic breast cancer. Int J Surg Case Rep. 2015;6C:280-4
7. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009 Jan;45(2):228-47.
8. Tsuda H, Akiyama F, Kurosumi M, Sakamoto G, Watanabe T. Monitoring of interobserver agreement in nuclear atypia scoring of node-negative breast carcinomas judged at individual collaborating hospitals in the National Surgical Adjuvant Study of Breast Cancer (NSAS-BC) protocol. Jpn J Clin Oncol. 1999;29:413-20.
9. Zhang L, Zhang J, Li Z, Wu Y, Tong Z. Comparison of the clinicopathological characteristics and prognosis between Chinese patients with breast cancer with bone-only and non-bone-only metastasis. Oncol Lett. 2020;20:92.
10. Niikura N, Liu J, Hayashi N, Palla SL, Tokuda Y, Hortobagyi GN, et al. Treatment outcome and prognostic factors for patients with bone-only metastases of breast cancer: a single-institution retrospective analysis. Oncologist. 2011;16:155-64.
11. Kai M, Kogawa T, Liu DD, Fouad TM, Kai K, Niikura N, et al. Clinical characteristics and outcome of bone-only metastasis in inflammatory and noninflammatory breast cancers. Clin Breast Cancer. 2015;15:37-42.
12. Ahn SG, Lee HM, Cho SH, Lee SA, Hwang SH, Jeong J, et al. Prognostic factors for patients with bone-only metastasis in breast cancer. Yonsei Med J. 2013;54:1168-77.