Factors affecting survival and treatment efficacy in breast cancer patients with bone marrow metastasis

Abstract

Bone marrow metastasis (BMM) from nonhematologic tumors is a well‐known clinical issue and most commonly associated with lung, breast, stomach, and prostate cancer.1 In early‐stage breast cancer (BC), bone marrow micrometastasis is observed in approximately 30% of patients and considered to be a poor prognostic factor. However, symptomatic and diffuse BMM is an extremely rare clinical condition that is estimated to occur in only 0.17% of BC patients.2 There is still no standard consensus to guide treatment in this spe‐ cific patient group.3 The aim of this study was to investigate the all possible factors including the demographic features prior to bone marrow biopsy (BMB), which might affect survival and treatment in metastatic BC patients with biopsy‐proven symptomatic BMM. From 2007 through 2017, medical records of BC patients from two major oncology clinics were reviewed retrospectively. A total of 30 BC patients presenting with cytopenia in whom the etiologi‐ cal cause of cytopenia could not be explained by simple laboratory parameters but was demonstrated to be associated with BMM by BMB were included. Patients <18 years of age, presence of a be‐ nign or malignant hematological disease, a second primary malig‐ nancy, history of drug use causing cytopenia, negative finding for BMB, and patients with missing data were excluded. Laboratory parameters were measured by routine blood tests before BMB. Median overall survival (mOS) was calculated as the time from the date of detection of BMM to the date of death or last follow‐up. Statistical analyses were carried out using Statistical Package for the Social Sciences 22.0 for Windows (IBM Corp.2013). The study was approved by the Ethics Committee of Okmeydani Training and Research Hospital(48670771‐514.10). TA B L E 1 Patient data