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The presenting dental status of solid tumours with bone metastases requiring bone-targeting agents - part 2: breast cancer

British Dental Journal volume 232, pages 95–100 (2022)Cite this article

Abstract

Introduction Patients with bony metastatic breast cancer (MBC) due to receive bone-targeting agents (BTA) are expected to undertake a dental assessment before commencing. The aim of this study was to determine the dental status of this tumour group and understand the challenges the dental practitioner faces in attempting to achieve 'dental fitness'.

Materials and methods Data were retrospectively collected from a dedicated pre-BTA dental assessment clinic and analysed for MBC. Statistical analysis and observational data were used to compare patient and tumour demographics.

Results A total of 229 patients were included in this cohort. On average, this cohort loses one tooth per decade (p = 0.003). Classifying the tumour sub-types provided observational differences in dental status with patients with triple negative MBC having the best dentition at presentation. These observations were more clinically profound when overlaid with survival following post-BTA dental assessment as patients with triple negative MBC had the lowest median survival (eight months, p = 0.002). In contrast, patients with luminal A breast cancer had a very complex presenting dentition with a median survival of 20 months.

Conclusion A clear difference exists in the outcomes of MBC patients and therefore a pre-BTA dental assessment should consider and integrate both patient and tumour demographics into dental treatment planning.

Key points

  • Annually, approximately 55,000 patients are diagnosed with breast cancer, with a significant proportion of them prescribed bone-targeting agents in either an adjuvant or metastatic setting.

  • In general, metastatic breast cancer patients have a higher survival rate than most other metastatic tumour groups.

  • Gene expression and hormone receptor status are key factors dictating oncology treatments and survival outcomes.

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Authors and Affiliations

  1. Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, London, UK

    Vinod Patel, Rana Wali, Megan Burns, Sheelen Patel & Marianne Henien

  2. Oral and Maxillofacial Surgery Department, Torbay Hospital, UK

    Sanford Grossman

  3. Computer Science Department, Brunel University, London, Kingston Lane, Uxbridge, UB8 3PH, UK

    Isabel Sassoon

  4. Medical Oncology, Guy´s and St Thomas´ NHS Foundation Trust, London, UK

    Janine Mansi

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Correspondence to Vinod Patel.

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19/LO/1600 - Dental status of oncology patients requiring bone modulating therapy - a retrospective cohort study.

There are no conflicts of interest to declare by any of the authors for this submitted work.

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Patel, V., Wali, R., Burns, M. et al. The presenting dental status of solid tumours with bone metastases requiring bone-targeting agents - part 2: breast cancer. Br Dent J 232, 95–100 (2022). https://doi.org/10.1038/s41415-022-3875-9

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