Breast cancer bone metastasis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-In-Chief: Jack Khouri

Overview

Bone is the most common site of breast cancer distant spread. Bone metastases due to breast cancer cause major morbidity, decrease survival and reduce quality of life of many patients. Cancer influence on the skeleton results in two main negative consequences: pain and Skeletal-Related events (sre), defined as any of the following:

• pathologic fracture,
• a requirement for surgical intervention and palliative radiotherapy to bone lesions,
• spinal cord compression,
• hypercalcemia of malignancy.

Many disciplines should be involved in the management of breast cancer bone metastases, including medical oncology, pain and palliative care, radiation oncology and orthopedic surgery. Systemic therapy is implemented in order to delay the progression of bone metastases and may include endocrine therapy, biologic agents, chemotherapy, and bisphosphonate therapy and osteoclast inhibitors.

Pathogenesis

The normal balance between bone resorption and deposition is significantly affected by cancer. Bone metastases due to breast cancer are mostly osteolytic lesions, though a considerable number of patients have predominant osteoblastic disease .