Title:Evaluation of Bone Scan Index as a Prognostic Tool in Breast Cancer
Patients with Bone Metastasis
Volume: 16
Issue: 4
Author(s): Maria Silvia De Feo, Viviana Frantellizzi*, Arianna Di Rocco, Alessio Farcomeni, Antonio Matto, Andrea Marongiu, Susanna Nuvoli, Angela Spanu and Giuseppe De Vincentis
Affiliation:
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza University of Rome, Rome, Italy
Keywords:
Bone scan index, breast cancer, bone metastasis, bone scintigraphy, overall survival (OS), tumor load.
Abstract:
Background: Bone metastatic involvement represents a leading cause of death in patients
with advanced breast cancer (BC). At present, it is not clear whether the bone metastatic
load might impact Overall Survival (OS) in patients with bone metastatic BC at diagnosis. For this
purpose, we used the Bone Scan Index (BSI), which is a reproducible and quantitative expression
of tumor load observed at bone scintigraphy.
Objective: The aim of this study was to associate BSI with OS in bone metastatic BC patients.
Methods: In this retrospective study, we enrolled BC patients with bone metastases at the scintigraphic
bone scan performed for staging purposes. The BSI was calculated through the DASciS
software, and statistical analysis was carried out. Other clinical variables relevant to OS analysis
were taken into account.
Results: Of a total of 94 patients, 32% died. In most cases, the histotype was ductal infiltrating
carcinoma. The median OS from diagnosis was 72 months (CI 95%: 62-NA). The univariate analysis
with COX regression showed that only hormone therapy significantly correlates with OS (HR
0.417, CI 95%: 0.174-0.997, p < 0.049). As concerning BSI, the statistical analysis showed that it
does not predict OS in BC patients (HR 0.960, 95% CI: 0.416-2.216, p < 0.924).
Conclusion: Although the BSI significantly predicts OS in prostate cancer and in other tumors, we
observed that the metastatic load of bone disease has not a key role in prognostic stratification in
our population.