Clinical significance and outcome of one or two rib lesions on bone scans in breast cancer patients without known metastases

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The presence of one or two rib lesions on bone scans of post-treatment breast cancer patients without known metastases often makes clinical decision making problematic. The aim of this study was to identify skeletal metastasis predictors that might help the management of these patients. We recruited post-treatment breast cancer patients without overt metastases whose bone scans showed (1) one or two rib hot spots, or (2) one rib lesion and a concurrent bone abnormality. Their clinical and serial scintigraphic data were collected, reviewed and evaluated for correlations. After their first abnormal bone scans, 23 patients (11 of the 77 patients initially with one rib lesion (incidence, 14.3%), three of the 27 patients with two rib lesions (incidence, 11.1%), and nine of the 11 patients with one rib lesion plus a concurrent bone abnormality (incidence, 81.8%)) developed multiple bone metastases within 2 years of the initial rib lesions in all but one case. Univariate analyses revealed that a concurrent bone lesion other than the rib, direct tumour invasion to the chest wall or skin, and 10 or more lymph nodes involved were associated with increased risks of bone metastases whereas longer persistence of the rib lesions was associated with a lower risk. Multivariate proportional hazard analyses indicated that patients with a concurrent bone lesion other than the rib (relative risk (RR) = 39.65; 95% confidence interval (CI) = 8.13-193.28), 10 or more lymph nodes involved (RR = 13.49; 95% CI = 2.09-86.91), and no radiotherapy (RR = 7.59; 95% CI = 2.11-27.39) were more likely to have bone metastases, while those with longer persistence of the rib lesions (RR = 0.92; 95% CI = 0.84-0.98) and longer time interval between surgery and the rib lesion detection (RR = 0.96; 95% CI = 0.94-0.99) were less likely. We have identified clinical features applicable to risk stratification. High incidence of bone metastases was noted in patients with one rib lesion and a concurrent bone abnormality. Regular follow-up for 2 years after detection of rib lesions is recommended, especially for those with risk factors.

Original languageEnglish
Pages (from-to)1167-1174
Number of pages8
JournalNuclear Medicine Communications
Volume24
Issue number11
DOIs
Publication statusPublished - 2003 Nov

Fingerprint

Ribs
Breast Neoplasms
Neoplasm Metastasis
Bone and Bones
Confidence Intervals
Incidence
Lymph Nodes
Thoracic Wall
Radiotherapy

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{75e45db9d0154daab58c33d4f4f26e82,
title = "Clinical significance and outcome of one or two rib lesions on bone scans in breast cancer patients without known metastases",
abstract = "The presence of one or two rib lesions on bone scans of post-treatment breast cancer patients without known metastases often makes clinical decision making problematic. The aim of this study was to identify skeletal metastasis predictors that might help the management of these patients. We recruited post-treatment breast cancer patients without overt metastases whose bone scans showed (1) one or two rib hot spots, or (2) one rib lesion and a concurrent bone abnormality. Their clinical and serial scintigraphic data were collected, reviewed and evaluated for correlations. After their first abnormal bone scans, 23 patients (11 of the 77 patients initially with one rib lesion (incidence, 14.3{\%}), three of the 27 patients with two rib lesions (incidence, 11.1{\%}), and nine of the 11 patients with one rib lesion plus a concurrent bone abnormality (incidence, 81.8{\%})) developed multiple bone metastases within 2 years of the initial rib lesions in all but one case. Univariate analyses revealed that a concurrent bone lesion other than the rib, direct tumour invasion to the chest wall or skin, and 10 or more lymph nodes involved were associated with increased risks of bone metastases whereas longer persistence of the rib lesions was associated with a lower risk. Multivariate proportional hazard analyses indicated that patients with a concurrent bone lesion other than the rib (relative risk (RR) = 39.65; 95{\%} confidence interval (CI) = 8.13-193.28), 10 or more lymph nodes involved (RR = 13.49; 95{\%} CI = 2.09-86.91), and no radiotherapy (RR = 7.59; 95{\%} CI = 2.11-27.39) were more likely to have bone metastases, while those with longer persistence of the rib lesions (RR = 0.92; 95{\%} CI = 0.84-0.98) and longer time interval between surgery and the rib lesion detection (RR = 0.96; 95{\%} CI = 0.94-0.99) were less likely. We have identified clinical features applicable to risk stratification. High incidence of bone metastases was noted in patients with one rib lesion and a concurrent bone abnormality. Regular follow-up for 2 years after detection of rib lesions is recommended, especially for those with risk factors.",
author = "Chen, {H. H.W.} and SU, {W. C.} and Guo, {H. R.} and Lee, {B. F.} and SU, {W. R.} and WU, {P. S.} and Chiu, {N. T.}",
year = "2003",
month = "11",
doi = "10.1097/00006231-200311000-00007",
language = "English",
volume = "24",
pages = "1167--1174",
journal = "Nuclear Medicine Communications",
issn = "0143-3636",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - Clinical significance and outcome of one or two rib lesions on bone scans in breast cancer patients without known metastases

AU - Chen, H. H.W.

AU - SU, W. C.

AU - Guo, H. R.

AU - Lee, B. F.

AU - SU, W. R.

AU - WU, P. S.

AU - Chiu, N. T.

PY - 2003/11

Y1 - 2003/11

N2 - The presence of one or two rib lesions on bone scans of post-treatment breast cancer patients without known metastases often makes clinical decision making problematic. The aim of this study was to identify skeletal metastasis predictors that might help the management of these patients. We recruited post-treatment breast cancer patients without overt metastases whose bone scans showed (1) one or two rib hot spots, or (2) one rib lesion and a concurrent bone abnormality. Their clinical and serial scintigraphic data were collected, reviewed and evaluated for correlations. After their first abnormal bone scans, 23 patients (11 of the 77 patients initially with one rib lesion (incidence, 14.3%), three of the 27 patients with two rib lesions (incidence, 11.1%), and nine of the 11 patients with one rib lesion plus a concurrent bone abnormality (incidence, 81.8%)) developed multiple bone metastases within 2 years of the initial rib lesions in all but one case. Univariate analyses revealed that a concurrent bone lesion other than the rib, direct tumour invasion to the chest wall or skin, and 10 or more lymph nodes involved were associated with increased risks of bone metastases whereas longer persistence of the rib lesions was associated with a lower risk. Multivariate proportional hazard analyses indicated that patients with a concurrent bone lesion other than the rib (relative risk (RR) = 39.65; 95% confidence interval (CI) = 8.13-193.28), 10 or more lymph nodes involved (RR = 13.49; 95% CI = 2.09-86.91), and no radiotherapy (RR = 7.59; 95% CI = 2.11-27.39) were more likely to have bone metastases, while those with longer persistence of the rib lesions (RR = 0.92; 95% CI = 0.84-0.98) and longer time interval between surgery and the rib lesion detection (RR = 0.96; 95% CI = 0.94-0.99) were less likely. We have identified clinical features applicable to risk stratification. High incidence of bone metastases was noted in patients with one rib lesion and a concurrent bone abnormality. Regular follow-up for 2 years after detection of rib lesions is recommended, especially for those with risk factors.

AB - The presence of one or two rib lesions on bone scans of post-treatment breast cancer patients without known metastases often makes clinical decision making problematic. The aim of this study was to identify skeletal metastasis predictors that might help the management of these patients. We recruited post-treatment breast cancer patients without overt metastases whose bone scans showed (1) one or two rib hot spots, or (2) one rib lesion and a concurrent bone abnormality. Their clinical and serial scintigraphic data were collected, reviewed and evaluated for correlations. After their first abnormal bone scans, 23 patients (11 of the 77 patients initially with one rib lesion (incidence, 14.3%), three of the 27 patients with two rib lesions (incidence, 11.1%), and nine of the 11 patients with one rib lesion plus a concurrent bone abnormality (incidence, 81.8%)) developed multiple bone metastases within 2 years of the initial rib lesions in all but one case. Univariate analyses revealed that a concurrent bone lesion other than the rib, direct tumour invasion to the chest wall or skin, and 10 or more lymph nodes involved were associated with increased risks of bone metastases whereas longer persistence of the rib lesions was associated with a lower risk. Multivariate proportional hazard analyses indicated that patients with a concurrent bone lesion other than the rib (relative risk (RR) = 39.65; 95% confidence interval (CI) = 8.13-193.28), 10 or more lymph nodes involved (RR = 13.49; 95% CI = 2.09-86.91), and no radiotherapy (RR = 7.59; 95% CI = 2.11-27.39) were more likely to have bone metastases, while those with longer persistence of the rib lesions (RR = 0.92; 95% CI = 0.84-0.98) and longer time interval between surgery and the rib lesion detection (RR = 0.96; 95% CI = 0.94-0.99) were less likely. We have identified clinical features applicable to risk stratification. High incidence of bone metastases was noted in patients with one rib lesion and a concurrent bone abnormality. Regular follow-up for 2 years after detection of rib lesions is recommended, especially for those with risk factors.

UR - http://www.scopus.com/inward/record.url?scp=3042528144&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3042528144&partnerID=8YFLogxK

U2 - 10.1097/00006231-200311000-00007

DO - 10.1097/00006231-200311000-00007

M3 - Article

C2 - 14569171

AN - SCOPUS:3042528144

VL - 24

SP - 1167

EP - 1174

JO - Nuclear Medicine Communications

JF - Nuclear Medicine Communications

SN - 0143-3636

IS - 11

ER -