摘要
Background: Breast cancer is the most frequent cancer among women and is a significant contributor to cancerrelated mortality. Advanced stages of the disease have been associated with distant metastasis, more prominently, to the bone. Responsible for debilitating complications such as bone pain, pathological fractures, and spinal cord compression, it is important to determine the pattern of clinical presentation of bony metastases in patients with breast cancer. The aim of this study was to determine the clinical and radiological pattern, and distribution of bone metastases in Nigerian breast cancer patients.
Methods: Sociodemographic, clinical, and radiological data of patients diagnosed with breast cancer between 2001 and 2010 were extracted from medical records.
Results: Out of a total of 311 patients with bony metastases, 41.5% presented within twelve months of diagnosis with skeletal metastases, At presentation, 46.6% were at stage III of the primary disease while 21.2% and 29.3% were in stages II and IV respectively. 30.5% had solitary bone metastasis while 69.5% had metastases to multiple bones. 89.7% presented with bone pain, 19.3% with cord compression, and 12.5% with fractures. The spine and pelvis were the most involved bones (66.6% and 34.7% respectively). 48.2% also had co-existing lung, liver, or brain metastases.
Conclusion: This study shows that patients with younger ages at diagnosis, those with axillary nodal involvement, and poorly differentiated tumors were found to have an increased risk of bone metastases. We advise that patients presenting at any stage be thoroughly screened for early detection of bone metastases.
Keyword: Metastases, breast cancer, sociodemographic, clinical
Résumé
Contexte: Le cancer du sein est le cancer le plus fréquent chez les femmes et contribue de manière significative à la mortalité liée au cancer. Les stades avancés de la maladie ont été associés à des métastases distant, plus en évidence, à l’os. Responsable à des complications débilitantes telles que les douleurs osseuses, les fractures pathologiques et la compression de la moelle épinière, il est important de déterminer le schéma de présentation clinique des métastases osseuses chez les patients atteints d’un cancer du sein. Le but de cette étude était de déterminer le schéma clinique et radiologique et la distribution des métastases osseuses chez les patients nigérians atteints d’un cancer du sein.
Méthodes: Les données sociodémographiques, cliniques et radiologiques des patients diagnostiqués avec un cancer du sein entre 2001 et 2010 ont été extraites des dossiers médicaux.
Résultats: Sur un total de 311 patients présentant des métastases osseuses, 41,5% présentaient dans les douze mois suivant le diagnostic des métastases squelettiques, à la présentation, 46,6% étaient au stade III de la maladie primaire tandis que 21,2% et 29,3% étaient aux stades II et IV respectivement. 30,5% avaient des métastases osseuses solitaires tandis que 69,5% avaient des métastases à plusieurs os. 89,7% présentaient des douleurs osseuses, 19,3% avec une compression du cordon et 12,5% avec des fractures. La colonne vertébrale et le bassin étaient les os les plus touchés (66,6% et 34,7% respectivement). 48,2% avaient également des métastases pulmonaires, hépatiques ou cérébrales concomitantes.
Conclusion: Cette étude montre que les patients avec un âge plus jeune au moment du diagnostic, ceux présentant une atteinte ganglionnaire axillaire, et des tumeurs mal différenciées présentaient un risque accru de métastases osseuses. Nous conseillons aux patients qui se présentent à tout stade de subir un dépistage minutieux pour une détection précoce des métastases osseuses.
Mots clés: Métastases osseuses, cancer du sein, sociodémographique, colonne vertébrale, bassin
Correspondence: Dr. O.A. Fatiregun, Oncology Unit, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. Email:omolarafatiregun@gmail.com
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