Skeletal metastases in 301 breast cancer patients: patient survival and complications after surgery

Rüdiger J Weiss; Elias Tullberg; Jonathan A Forsberg; Henrik C Bauer; Rikard Wedin

doi:10.1016/j.breast.2014.02.012

Skeletal metastases in 301 breast cancer patients: patient survival and complications after surgery

Breast. 2014 Jun;23(3):286-90. doi: 10.1016/j.breast.2014.02.012. Epub 2014 Mar 27.

Authors

Rüdiger J Weiss¹, Elias Tullberg², Jonathan A Forsberg², Henrik C Bauer², Rikard Wedin²

Affiliations

¹ Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden. Electronic address: rudiger.weiss@karolinska.se.
² Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden.

PMID: 24684891
DOI: 10.1016/j.breast.2014.02.012

Abstract

The aim was to identify prognostic variables associated with survival in 301 breast cancer patients after surgical treatment of skeletal metastases. The study period was 1986-2012. The median age at surgery was 61 (interquartile-range [IQR] 52-70) years. The cumulative 1-, 2-, and 5-year survival after surgery was 45% (95% CI 39-51), 27% (22-32), and 8% (5-12), respectively. The median follow-up time was 1 (IQR 0.2-2) year. Age over 60 years (Hazard ratio [HR] 1.9) and hemoglobin levels <110 g/L (HR 2) increased the risk of death after surgery. Patients with impending fractures (HR 0.4) had a lower death rate. The overall neurological function in patients with spinal metastases improved after surgery (p < 0.001). The complication rate was 25%, including 14% re-operations. Survival data and analysis of complications of this large cohort of surgically treated breast cancer patients help to set appropriate expectations for the patients, families, and medical staff.

Keywords: Breast cancer; Complication; Outcome; Re-operation; Skeletal metastases; Surgery.

MeSH terms

Age Factors
Bone Neoplasms* / complications
Bone Neoplasms* / mortality
Bone Neoplasms* / secondary
Bone Neoplasms* / surgery
Breast Neoplasms / blood
Breast Neoplasms / mortality
Breast Neoplasms / pathology
Female
Fractures, Spontaneous / epidemiology
Fractures, Spontaneous / etiology
Hemoglobins / analysis*
Humans
Life Expectancy*
Middle Aged
Orthopedic Procedures* / adverse effects
Orthopedic Procedures* / methods
Orthopedic Procedures* / statistics & numerical data
Postoperative Complications* / classification
Postoperative Complications* / epidemiology
Prognosis
Registries
Reoperation
Risk Assessment
Risk Factors
Survival Rate
Sweden / epidemiology

Substances

Hemoglobins