Prevalence and risk of skeletal complications and use of radiation therapy in elderly women diagnosed with metastatic breast cancer

Real-world data regarding patient factors associated with the occurrence of spinal cord compression (SCC) or pathological fracture (PF), or need for bone surgery (BS), or use of radiation therapy (RAD) (i.e. skeletal complications and radiation therapy; SCRT) are limited for women with metastatic br...

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Bibliographic Details
Published in:PloS one 2018-03, Vol.13 (3), p.e0193661
Main Authors: Hussain, Arif, Yong, Candice, Tkaczuk, Katherine H R, Qian, Yi, Arellano, Jorge, Mullins, C Daniel, Onukwugha, Eberechukwu
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biology and Life Sciences
Bone transplantation
Breast Neoplasms - epidemiology
Breast Neoplasms - radiotherapy
Care and treatment
Female
Fractures, Spontaneous - epidemiology
Fractures, Spontaneous - etiology
Fractures, Spontaneous - surgery
Humans
Medicare
Medicine and Health Sciences
Neoplasm Metastasis
Prevalence
Radiotherapy
Risk Factors
SEER Program
Spinal cord compression
Spinal Cord Compression - epidemiology
Spinal Cord Compression - etiology
Spinal Cord Compression - surgery
United States - epidemiology
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Summary:Real-world data regarding patient factors associated with the occurrence of spinal cord compression (SCC) or pathological fracture (PF), or need for bone surgery (BS), or use of radiation therapy (RAD) (i.e. skeletal complications and radiation therapy; SCRT) are limited for women with metastatic breast cancer (BCa). Given the substantial clinical and economic burden of these events in advanced BCa, we conducted the present study to understand the prevalence and identify the risk factors associated with these events among elderly women presenting with de novo metastatic BCa. Using linked Surveillance, Epidemiology, and End Results and Medicare data, we identified women with incident metastatic BCa diagnosed during 2005-2009. Associations between patient demographics and select clinically relevant factors, and SCRT were examined using the Cox proportional hazards model, accounting for death as a competing risk. Of 3,731 Medicare beneficiaries with incident metastatic BCa, 1,808 (48.5%) experienced at least one SCRT event during a median follow-up of 13.2 months; a majority (69%) experienced a subsequent SCRT event. The proportions of women who had RAD, PF, BS, and SCC were: 32%, 28%, 8%, and 4%. Older women (80+ years), or those with more comorbid conditions (CCI≥2) had a statistically significant lower risk of SCRT (HR 0.78 [CI: 0.67-0.92, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0193661