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

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 sin...

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Main Authors: Eman Anwar, Aqsa Amjad, Akbar Jaleel Zubairi, Muhammad Maisam Ali, Sana Zeeshan
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14187-9
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Summary: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.
ISSN:1471-2407