De Novo bone metastasis in breast cancer: Tumor biology and survival outcomes in a retrospective study from Pakistan

Document Type

Article

Department

Medical College Pakistan; Surgery; Breast Surgery; Orthopaedic Surgery

Abstract

Purpose: Breast cancer is the leading cause of cancer-related deaths among women, with 20-30% of early-stage patients eventually developing metastases, often in bones. Despite the high incidence, risk factors for de novo bone metastasis are understudied in local populations.
Methods: This single-center, retrospective study was conducted at Aga Khan University Hospital, Karachi. Patient demographics, tumor characteristics, and risk factors were assessed. Patients with de novo bone metastasis were compared to non-stage IV cases using binary univariate and multivariate logistic regression, with significance set at p < 0.05.
Results: Among 2565 patients, 93 (3.6%) presented with bone only metastasis (BOM) and 135 (5.3%) presented with bone and visceral metastasis together. The median age was 51 years, with females predominating. Multivariate analysis revealed that triple-negative breast carcinoma had lower odds (OR 0.36, 95% CI (0.16-0.79) p < 0.001). Advanced T and N stages and tumor grade II were linked to higher odds of bone-only metastasis. The 2-year overall survival of participants with BOM was 93% (CI: 83.7-97%).
Conclusion: This study identifies key risk factors that provide the basis for early detection and intervention strategies. While it has a few limitations, these findings can guide future research and inform risk assessment models for more diverse populations.

Publication (Name of Journal)

BMC Cancer

DOI

10.1186/s12885-025-14187-9

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