Influence of receptor status and proliferation index in skeletal metastases of breast carcinoma on pathological fracture occurrence

Abstract Purpose. Bones affected with metastatic breast carcinoma are prone to pathological fracture, impairing quality of life and survival rate. This study examined estrogen, progesterone, and HER2 receptors status, and Ki-67 index in skeletal metastases of breast carcinoma and their potential influence on pathological fracture occurrence.Methods. The study included 152 samples of skeletal metastasis of breast carcinoma, each obtained from an individual patient. Allred’s score was used for immunohistochemical interpretation. Clinical and radiological data were gathered from each patient`s history of the disease.Results. Femur stood out as an independent risk factor – it had a nine times higher chance for pathological fracture than other bones. Estrogen receptors, HER2, and Ki-67 status had no statistical significance for pathological fracture occurrence. Progesterone receptors showed significance for fracture development. The probability of fracture in progesterone receptor positive metastases was 68,1%, risk increasing with the rise of positive cells percentage, regardless of the expression intensity.Conclusion. Receptor status is important for skeletal metastases of breast carcinoma and can be used in clinical decision-making for systemic therapy and surgical treatment in fracture prevention.