Published online Sep 24, 2025. doi: 10.5306/wjco.v16.i9.110087
Revised: June 24, 2025
Accepted: August 5, 2025
Published online: September 24, 2025
Processing time: 117 Days and 17.6 Hours
Bone is the most common site of metastasis in breast cancer, yet limited data exist regarding the precise anatomical distribution of bone metastases by tumor su
To examine the anatomical distribution of the first bone metastases in stage IV breast cancer, stratified by histological subtype. Secondary objectives include analyzing the anatomical distribution of subsequent bone metastases, Metastasis-Free Survival (MFI), Progression-Free Interval (PFI), and overall survival (OS).
A retrospective cohort study was conducted on 107 adult females with stage IV breast cancer and bone metastases between 2013 and 2023. Patients were classified by histological subtype (Luminal A/B, HER2-enriched, and Triple-Negative). First and subsequent bone metastasis locations were identified via computed tomo
Rib metastases were significantly more common in HER2-enriched tumors (80%, P = 0.041), while scapula/clavicle metastases were more prevalent in Triple-Negative cases (37.5%, P = 0.003). Subsequent bone metastases mirrored initial patterns, with pelvic involvement notably higher in HER2-enriched (60%) and luminal B (58%) patients (P = 0.046). No significant differences were found in MFI, PFI, or OS among subtypes. Receptor-based analysis showed no significant variation in bone metastasis locations.
Breast cancer subtypes are associated with suggestive bone metastasis patterns—specifically, rib involvement in HER2-enriched and scapula/clavicle in Triple-Negative cases. While anatomical variations exist, they did not translate into differential survival or fracture risk in this cohort.
Core Tip: This study investigates the anatomical distribution of bone metastases in stage IV breast cancer, stratified by histological subtype. Unlike previous reports focusing on general metastatic trends, our analysis highlights specific skeletal predilections-such as rib involvement in HER2-enriched tumors and scapula/clavicle in triple-negative cases. Despite these patterns, survival outcomes and fracture rates did not significantly differ. These findings support a unified clinical approach while offering new insights that may refine imaging surveillance strategies.