Risk factors for bone metastasis in breast cancer:A systematic review
Objective To systematically review the incidence and risk factors of bone metastasis in breast cancer patients do-mestically and internationally,providing basis for clinical prevention and reduction of the incidence of bone metastasis.Methods CNKI,VIP,Wanfang,Chinese Biomedical Literature Database,PubMed,Medline,Scopus,The Cochrane Library,Web of Science,Em-base were searched for articles on risk factors or influencing factors of bone metastasis of breast cancer published from the establishment of the database to April 17,2024.The literature was screened according to the inclusion and exclusion criteria,and Revman5.4 and Sta-ta17.0 were used for systematic review.Results A total of 27 articles were included in this study,including 307,993 breast cancer pa-tients,of which 12,283 patients had bone metastases.Meta-analysis showed that there was significant statistical heterogeneity among the included studies(I2=99.1%,P<0.001).Using the random effects model,the incidence of bone metastasis was 27.8%[95%CI(0.232,0.324),P<0.001].The risk factors of bone metastasis were age(≤40 years,≥50 years),lymph node positivity,visceral me-tastasis,late clinical stage(Ⅲ,Ⅳ),tumor diameter≥5cm,high expression of Ki-67,increased levels of tumor markers(CEA,CA125),low expression of biomarker(nm23 protein),increased ALP level,and low Hb level,Molecular typing(luminal,TNBC).Con-clusion Medical staff should pay more attention to high-risk patients and take preventive measures and treatment as soon as possible.
Breast cancerBone metastasisRisk factorsThe influencing factorsSystematic review
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