Bone Fracture in Breast Cancer Patients with Isolated Bone Metastasis

Aim: To analyse the incidence of bone fracture of breastcancer patients with isolated bone metastasis and its effecton survival. We tried to find an answer to the question of“Can the development of bone fracture be predicted?”Methods: Between 1993-2006, 139 breast cancer patientswith isolated bone metastasis were examined. Patients weredivided into two groups depending on the development ofpathologic bone fracture.Results: Fractures were developed in 41 patients (29.5%)within 41 months of follow-up. The locations of pathologicbone fracture were vertebral fracture in 26 patients (63.4%),femur fracture in 11 patients (26.8%), and hip fracture infour patients (9.8%). Fracture rates in hormone sensitive andresistant patients were 31.2% and 14.3%, respectively. Thefracture rates in 13 triple negative and non triple negativepatients were 7.7% and 31.4%, respectively (p=0.07). HighCA 15-3 levels at the time of metastasis in patients with andwithout fractures were 68.4% and 61.1%, respectively. Therisk for fracture was also high in Her2-neu positive patients (38.7% vs. 26.5%). While the incidence of fracture with thepresence of one factor mentioned above was 22.2%, it wasincreased to 36.1% in the presence of two or three factors(p=0.13). Median survivals of the patients with and withoutfractures were 48 and 39 months, respectively (p= 0.65).Conclusion: Hormone sensitivity, high CA 15-3 levels andpositive Her2-neu status are slight risk factors for bonefractures. Survival was not different in patients with or withoutbone fractures.

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