Systematic review and meta-analysis on the proportion of patients with breast cancer who develop bone metastases

https://doi.org/10.1016/j.critrevonc.2017.04.008Get rights and content
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Highlights

  • Systematic review and meta-analysis of bone metastases in those with breast cancer.

  • Included data from more than 175,000 patients with breast cancer.

  • 12% of patients with stage I–III breast cancer developed bone metastases.

  • Of those who developed any metastases during follow-up, 55% had bone metastases.

  • Of patients with metastatic breast cancer at study start, 58% had bone metastases.

Abstract

A systematic literature review was conducted to quantify populations of patients with primary breast cancer in whom bone metastases were detected at study start or during follow-up. Searches were performed in PubMed and EMBASE using terms related to breast cancer and bone metastases. Articles had to have been published 01/01/99–31/12/13, and to report data on the proportion of patients with bone metastases among patients with breast cancer. In total, 156 articles were included in the meta-analysis. A median of 12% of patients with stage I–III breast cancer developed bone metastases during a median follow-up of 60 months. Of patients who developed metastatic disease during follow-up, 55% (median) had bone metastases. Of those with metastatic breast cancer at study start, 58% (median) had bone metastases. These data help to inform on the global burden of bone metastases by defining patient populations that are at risk of developing bone metastases.

Keywords

Breast cancer
Bone metastases
Bone metastasis
Incidence
Prevalence

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Professor Jean-Jacques Body has been trained as a medical oncologist and an endocrinologist. He is Head of the Department of Medicine at University Hospital Brugmann in Brussels and Full Professor of Medicine (Internal Medicine) at the “Université Libre de Bruxelles”, Brussels, Belgium. He was previously Head of the Internal Medicine Clinic at Institute J. Bordet (Cancer Center of “Université Libre de Bruxelles”). He has also developed the “Supportive Care Dept” at the same Institute. His particular research interests are bone metastases and osteoporosis, including cancer treatment-induced bone loss. He was involved in numerous trials in cancer patients with all bisphosphonates available in Europe and with denosumab from phase I to phase IV. He has a long-standing interest for bone metabolism and turnover in metastatic bone disease and in osteoporosis. He has authored or co-authored more than 250 international peer-reviewed papers (H index >55), about 65 book chapters or proceedings and he counts more than 200 invited lectures for international meetings.

Geoffrey Quinn has an MSc in Biometry from the University of Reading and has worked in the pharmaceutical industry as a Statistician for 20 years. He is currently a Director of Statistics in the Respiratory therapeutic area at AstraZeneca.

Susan Talbot studied an undergraduate degree in Probability and Statistics (University of Sheffield, UK) and an MSc in Biometry (University of Reading, UK). She has worked in the Pharmaceutical Industry for 18 years, and is currently the European Biostatistics Lead for the Oncology therapeutic area at Amgen Ltd. Susan and her team support the product life cycle activities including the design, analysis and reporting of clinical trials and observational research, and support HTA activities. She joined Amgen in 2006 and previously worked as the Statistics Manager at Statwood Ltd.

Emma Booth is a Medical Writer with over 10 years’ experience in developing publications and medical communication materials for oncology healthcare professionals. She completed her studies in Biomedical Sciences at Durham University, UK with research focus in the correlation between the staining intensity of glioblastomas and survival outcomes. Since 2008, Emma has been an employee of Amgen (Europe) GmbH, based in Zug, Switzerland.

Gaston Demonty obtained his medical degree from Universidad de Buenos Aires, Argentina in 1997 and completed training in Internal Medicine and Clinical Oncology in Argentina. He moved to Europe in 2003 to complete a 2 year fellowship in clinical research in breast cancer at Martine Piccart's department at the Jules Bordet Institute in Belgium. In 2005, he joined the EORTC as a Clinical Research Physician for the Breast Cancer Group, the Gynecological Cancer Group, and the Cancer in the Elderly Task Force. Since 2008, Gaston has been an employee of Amgen based in Brussels, Belgium.

Dr Aliki Taylor is a public health physician by training and an epidemiologist. She is currently working as Director of Global Outcomes Research at Takeda. She is based in the London office and focuses on oncology, working directly with countries and with regulatory, market access, medical and safety teams to determine needs for real world evidence in Europe, supporting marketed products. She is also the Takeda lead for IMI projects, and is involved in three IMI initiatives. She is a member of Association of British Pharmaceutical Industries (ABPI) cancer data sets group within the Pharmaceutical Oncology Initiative. Prior to working at Takeda, she was Observational Research Medical Director at Amgen from 2009–2015. There she was the lead for European oncology studies at the Centre for Observational Research (CfOR), managing a team of six staff, five of whom were epidemiologists. Prior to working in industry, Dr Taylor was based at the University of Birmingham from 2002–2009 where she carried out a PhD in cancer epidemiology as part of a Cancer Research UK Fellowship in Cancer Public Health and Epidemiology. From 2007–2009 she worked as a post doc and clinical research fellow in the Dept of Public Health and Epidemiology. From 1994–2002 she worked in the NHS, after qualifying as a doctor from University College London in 1994. She first worked as a medical doctor in a variety of posts in medicine and before training as a public health doctor, during 1997–2002. Her qualifications in addition to higher specialist public health training in medicine are MBBS, BSc (Anthropology), MPH and PhD. She has published in a number of international journals over the years, primarily in the area of cancer epidemiology and observational research.

Justyna Amelio is an epidemiologist with a PhD in public health. Her experience encompasses scientific and operational aspects of observational research design, management, and execution. She has worked in a variety of environments with main focus on oncology related research. In addition, she has research experience in other therapeutic areas such as: cardiology, gastroenterology, autoimmune diseases, reproductive health, nutrition and others. She is passionate about staying abreast of current trends in epidemiology/public health.