Zhang PZ, Wang YJ, Xu YK. Letter to the Editor: Revisiting the anatomical pattern of bone metastases in stage IV breast cancer: Missing clinical stratification and biological depth. World J Clin Oncol 2026; 17(5): 114734 [DOI: 10.5306/wjco.v17.i5.114734]
Corresponding Author of This Article
Ying-Kun Xu, MD, PhD, Assistant Professor, Department of General Surgery, Qilu Hospital of Shandong University, No. 107 Wenhua West Road, Lixia District, Jinan 250012, Shandong Province, China. yingkunxu@hotmail.com
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Oncology
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May 24, 2026 (publication date) through May 20, 2026
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World Journal of Clinical Oncology
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2218-4333
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Zhang PZ, Wang YJ, Xu YK. Letter to the Editor: Revisiting the anatomical pattern of bone metastases in stage IV breast cancer: Missing clinical stratification and biological depth. World J Clin Oncol 2026; 17(5): 114734 [DOI: 10.5306/wjco.v17.i5.114734]
World J Clin Oncol. May 24, 2026; 17(5): 114734 Published online May 24, 2026. doi: 10.5306/wjco.v17.i5.114734
Letter to the Editor: Revisiting the anatomical pattern of bone metastases in stage IV breast cancer: Missing clinical stratification and biological depth
Pei-Zhi Zhang, Yan-Jie Wang, Ying-Kun Xu
Pei-Zhi Zhang, Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Yan-Jie Wang, Departments of Ultrasound, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250014, Shandong Province, China
Ying-Kun Xu, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Author contributions: Zhang PZ and Wang YJ contributed to drafting the manuscript; Xu YK contributed to revising the manuscript for important intellectual content; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Ying-Kun Xu, MD, PhD, Assistant Professor, Department of General Surgery, Qilu Hospital of Shandong University, No. 107 Wenhua West Road, Lixia District, Jinan 250012, Shandong Province, China. yingkunxu@hotmail.com
Received: September 27, 2025 Revised: December 1, 2025 Accepted: February 3, 2026 Published online: May 24, 2026 Processing time: 235 Days and 22.4 Hours
Abstract
The recent article by Zari et al published in World Journal of Clinical Oncology on bone metastases patterns in stage IV breast cancer offers valuable insight by stratifying anatomical distribution according to histological subtypes. However, some important clinical and biological aspects remain insufficiently addressed. For instance, the lack of data on diagnostic imaging methods, prior systemic therapies, and metastatic burden limits the interpretation of survival outcomes. Moreover, the prognostic implications of specific skeletal sites, such as spinal vs appendicular involvement are not fully discussed. We believe that integrating anatomical findings with clinical history and biological markers would offer a more complete understanding and greater translational value.
Core Tip: This letter highlights several overlooked aspects in a recent study on bone metastases in breast cancer, including the absence of molecular subtype stratification, survival outcomes, and lesion-level anatomical detail. We argue that incorporating imaging approaches, clinical context, and biomarker profiles is essential to make such anatomical findings more clinically meaningful and translatable.
