Rhys Morris1, Karen Shepherd2, Gillian Cribb2, Jaspreet Singh3, Prudencia Tyrrell3, Paul Cool2,4. 1. Montgomery Unit, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK. rm502@doctors.org.uk. 2. Montgomery Unit, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK. 3. Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK. 4. Keele University, Newcastle, Staffordshire, ST5 5BG, UK.
Abstract
OBJECTIVE: The value of a bone biopsy in patients who present with a bone lesion and past medical history of malignancy is uncertain. The objective of this study was to evaluate the outcome of bone biopsies in patients with a history of a malignancy undergoing bone biopsy of a lesion in a regional bone tumour unit. Secondary outcomes include the assessment of survival in the different outcome groups. MATERIALS AND METHODS: This was a retrospective study of patients, with a previous malignancy and suspicious bone lesions, who underwent bone biopsy for final diagnosis between March 2010 and September 2019. Results of the biopsy were summarized into 3 groups: confirmed original malignancy, confirmed benign diagnosis, and confirmed new malignancy. Survival analysis of each group was also undertaken. RESULTS: A total of 378 patients met the inclusion criteria (mean age 64 years, 216 females (57%)). In 250 cases (66%), the original malignancy was confirmed on the bone biopsy; in 128 cases, an alternative diagnosis was confirmed (benign diagnosis in 69 (18%)), and 59 had a new malignancy (16%). Survival was significantly greater for those in whom a benign diagnosis was confirmed (logrank test p = 0.0100). CONCLUSION: This study shows that for patients presenting with a suspicious bone lesion, together with a history of malignancy, in a third of cases, the bone biopsy will confirm an alternative diagnosis of a benign lesion or a new malignancy. Survival of these patients will vary significantly depending on the biopsy outcome.
OBJECTIVE: The value of a bone biopsy in patients who present with a bone lesion and past medical history of malignancy is uncertain. The objective of this study was to evaluate the outcome of bone biopsies in patients with a history of a malignancy undergoing bone biopsy of a lesion in a regional bone tumour unit. Secondary outcomes include the assessment of survival in the different outcome groups. MATERIALS AND METHODS: This was a retrospective study of patients, with a previous malignancy and suspicious bone lesions, who underwent bone biopsy for final diagnosis between March 2010 and September 2019. Results of the biopsy were summarized into 3 groups: confirmed original malignancy, confirmed benign diagnosis, and confirmed new malignancy. Survival analysis of each group was also undertaken. RESULTS: A total of 378 patients met the inclusion criteria (mean age 64 years, 216 females (57%)). In 250 cases (66%), the original malignancy was confirmed on the bone biopsy; in 128 cases, an alternative diagnosis was confirmed (benign diagnosis in 69 (18%)), and 59 had a new malignancy (16%). Survival was significantly greater for those in whom a benign diagnosis was confirmed (logrank test p = 0.0100). CONCLUSION: This study shows that for patients presenting with a suspicious bone lesion, together with a history of malignancy, in a third of cases, the bone biopsy will confirm an alternative diagnosis of a benign lesion or a new malignancy. Survival of these patients will vary significantly depending on the biopsy outcome.
Entities:
Keywords:
Bone biopsy; Bone lesion; Cancer; Metastatic bone disease