Analysis Of Clinical Characteristics And Risk Factors Of Breast Cancer Patients With Bone Metastases

Objective:To evaluate the incidence and distribution of breast cancer bone metastases.We aimed to explore the correlation between clinicopathological parameters and bone metastases,and to identify risk factors for bone metastases in breast cancer patients.Methods:A total of 1448 patients diagnosed with breast cancer in our hospital from January 2010 to December 2019 were included in this study.The differences in age,menopausal status,histological type,tumor size,histological grade,lymphovascular invasion,number of axillary lymph node metastases,molecular subtype,ALP,CEA,tumor antigen CA153,and HB were studied between the bone metastases(n=130)and the non-metastatic(n=1318)groups,respectively.The incidence and distribution of bone metastases from breast cancer were evaluated,and the correlation between diverse clinical-pathological parameters and bone metastases were analyzed in the study.The independent risk factors of bone metastases in breast cancer patients were determined by Logistic regression,and the cut-off value,sensitivity and specificity of single and combined factors were analyzed and calculated by using the ROC curve and the AUC of the subjects.Results:Univariate analysis showed statistically significant differences in tumor size,presence or absence of lymphovascular invasion,number of axillary lymph node metastases,molecular type,ALP,CEA,and CA153 in patients with and without bone metastasis(P<0.05).Multivariate logistic regression analysis showed that ALP,CA153 and lymphovascular invasion were the independent risk factors for bone metastases in patients with breast cancer.The ROC curves showed that combined axillary lymph node metastases,CA153 and ALP,with lymphovascular invasion had the highest predictive accuracy for predicting bone metastases in breast cancer(AUC=0.902),and the sensitivity and specificity for the prediction were 76.9% and 94.3%,respectively.Therefore,breast cancer patients with high serum concentrations of ALP,CA153,more axillary lymph node metastases,and lymphovascular invasion were closely related to bone metastases.Conclusion:ALP>71.2 u/L,CA153 >19.45 u/ml,number of axillary lymph node metastases,and lymphovascular invasion were identified as risk factors for bone metastases in patients with breast cancer.So patients with these characteristics should be monitored more precisely with regular follow-ups.