Prognostic factors in patients with breast cancer metastasis in the femur treated surgically

BACKGROUND: Breast carcinoma is a common malignancy in the developed world. Late diagnosis of the disease is associated with bone metastasis. The femur is commonly affected. Prognostic factors of mortality in patients with bone metastases originating from cancers in general have been reported. However, there is no specific report of prognostic factors in relation to breast cancer metastasis in the surgically treated femur. The determination of prognostic factors in patients with bone metastasis can assist in therapeutic decisions. OBJECTIVE: To determine clinical and orthopedic factors related to mortality in patients with breast cancer and metastases to the femur treated surgically. METHOD: This was a retrospective study and included 41 patients undergoing surgical treatment of femoral metastases. We analyzed the following variables: (i) number and location of bone metastases, (ii) visceral metastases, (iii) presence of pathological fracture, (iv) fixation method, and (v) laboratory tests. These factors were correlated with mortality using Cox Multivariate Logistic regression and Kaplan-Meier curves. RESULTS: There was a high prevalence of multiple metastases associated with pathological fractures at the time of surgery. Mortality was high and early. Subtrochanteric location, the presence of fractures, anemia, and alterations in renal function were associated with higher mortality. The fixation method, the number of bone metastases, and the presence of metastasis in other organs did not affect mortality. CONCLUSIONS: Breast cancer with metastasis to the femur is an advanced disease with early mortality. Clinical and orthopedic factors should be considered. Surgery is recommended when lesions occur, regardless of the type of implant used.