Abstract：
OBJECTIVE: Osteopenia, the loss of bone mineral density (BMD), was recently reported as a prognostic factor in various cancers. However, the prognostic significance of preoperative osteopenia in breast cancer remains unclear. This study aimed to clarify the clinical significance of preoperative osteopenia in breast cancer.
METHODS: We retrospectively analyzed the relationship between osteopenia and clinical factors and prognosis in 532 patients with pathological Stage I-III primary breast cancer between 2009 and 2017. Osteopenia was assessed by measuring the average pixel density (Hounsfield unit) in the midvertebral core of the 11th thoracic vertebra on enhanced preoperative computed tomography.
RESULTS: Osteopenia was diagnosed in 186 (35.0%) patients. The recurrence-free survival (RFS) rate was significantly worse in the osteopenia group than in the non-osteopenia group (p=0.0275), but there was no significant difference in overall survival (OS) between the two groups. When evaluated by menopausal status, RFS and OS were significantly worse in the osteopenia group than in the non-osteopenia group (p=0.0094 and p=0.0264, respectively) in premenopausal patients. However, there were no significant differences in RFS and OS between the two groups among postmenopausal patients. In premenopausal patients, osteopenia was an independent prognostic factor for RFS in a multivariate analysis (p=0.0266).
CONCLUSIONS: Preoperative osteopenia was independently associated with recurrence of breast cancer.
METHODS: We retrospectively analyzed the relationship between osteopenia and clinical factors and prognosis in 532 patients with pathological Stage I-III primary breast cancer between 2009 and 2017. Osteopenia was assessed by measuring the average pixel density (Hounsfield unit) in the midvertebral core of the 11th thoracic vertebra on enhanced preoperative computed tomography.
RESULTS: Osteopenia was diagnosed in 186 (35.0%) patients. The recurrence-free survival (RFS) rate was significantly worse in the osteopenia group than in the non-osteopenia group (p=0.0275), but there was no significant difference in overall survival (OS) between the two groups. When evaluated by menopausal status, RFS and OS were significantly worse in the osteopenia group than in the non-osteopenia group (p=0.0094 and p=0.0264, respectively) in premenopausal patients. However, there were no significant differences in RFS and OS between the two groups among postmenopausal patients. In premenopausal patients, osteopenia was an independent prognostic factor for RFS in a multivariate analysis (p=0.0266).
CONCLUSIONS: Preoperative osteopenia was independently associated with recurrence of breast cancer.
摘要：
目标：骨质减少，骨矿物质密度（BMD）的损失，最近被报道为各种癌症的预后因素。然而,术前骨量减少在乳腺癌中的预后意义尚不清楚.本研究旨在阐明乳腺癌术前骨量减少的临床意义。
方法：回顾性分析2009～2017年532例病理Ⅰ～Ⅲ期原发性乳腺癌患者骨量减少与临床因素及预后的关系。通过在增强的术前计算机断层扫描中测量第11胸椎中椎的平均像素密度（Hounsfield单位）来评估骨质减少。
结果：186例（35.0%）患者诊断为骨质减少。骨量减少组的无复发生存率(RFS)明显低于非骨量减少组(p=0.0275),但两组总生存期(OS)无显著差异。当通过绝经状态评估时，在绝经前患者中，骨量减少组的RFS和OS明显低于非骨量减少组（分别为p=0.0094和p=0.0264）。然而,绝经后两组患者的RFS和OS差异无统计学意义.在绝经前患者中，在多因素分析中,骨质减少是RFS的独立预后因素(p=0.0266).
结论：术前骨量减少与乳腺癌复发独立相关。
方法：回顾性分析2009～2017年532例病理Ⅰ～Ⅲ期原发性乳腺癌患者骨量减少与临床因素及预后的关系。通过在增强的术前计算机断层扫描中测量第11胸椎中椎的平均像素密度（Hounsfield单位）来评估骨质减少。
结果：186例（35.0%）患者诊断为骨质减少。骨量减少组的无复发生存率(RFS)明显低于非骨量减少组(p=0.0275),但两组总生存期(OS)无显著差异。当通过绝经状态评估时，在绝经前患者中，骨量减少组的RFS和OS明显低于非骨量减少组（分别为p=0.0094和p=0.0264）。然而,绝经后两组患者的RFS和OS差异无统计学意义.在绝经前患者中，在多因素分析中,骨质减少是RFS的独立预后因素(p=0.0266).
结论：术前骨量减少与乳腺癌复发独立相关。
