A new emergency in oncology: Bone metastases in breast cancer patients (Review)

Ibrahim,Toni; Mercatali,Laura; Amadori,Dino

doi:10.3892/ol.2013.1372

A new emergency in oncology: Bone metastases in breast cancer patients (Review)

Authors:
- Toni Ibrahim
- Laura Mercatali
- Dino Amadori
View Affiliations

Affiliations: Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola I‑47014, Italy
Published online on: June 4, 2013 https://doi.org/10.3892/ol.2013.1372
Pages: 306-310

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Breast cancer (BC) is the most common tumour in females and as a result, the management of such patients is a major public health issue. A high percentage of BC patients develop bone metastases (BMs), occasionally even several years following the initial diagnosis. BMs are responsible for high morbidity and a reduced quality of life with the onset of various clinical complications defined as skeletal‑related events (SREs), including pathological fractures, spinal cord compression, hypercalcaemia, bone marrow infiltration and severe bone pain, requiring palliative radiotherapy. Such complications reduce functional independence and quality of life, decrease survival rates and increase healthcare costs. The current treatment for metastatic BC aims to achieve meaningful clinical responses, an improved quality of life, long‑term remission, prolonged survival and in a small percentage of cases, a complete cure. The treatment of this malignancy has become progressively complex, including well‑known antitumour agents or bone‑targeted molecules aimed at preventing bone complications and improving patient quality of life and the treatment outcome of a multidisciplinary programme. The importance of a multidisciplinary approach in the management of BMs is also widely accepted. The major complication of BMs are SREs which are responsible for reducing prognoses and patient quality of life and are correlated with high rates of hospitalisation with the subsequent social and economic consequences. For these reasons, it is crucial to prevent where possible or to identify and treat SREs promptly in an attempt to mitigate the ever‑increasing clinical and economic burden.

View Figures

View References

1.	Jemal A, Siegel R, Ward E, Hao Y, Xu J and Thun MJ: Cancer statistics, 2009. CA Cancer J Clin. 59:225–249. 2009. View Article : Google Scholar
2.	Ibrahim T, Mercatali L, Casadei R and Sabbatini R: Clinical manifestation. Osteoncology textbook. Amadori D, Cascinu S, Conte P and Ibrahim T: Poletto editore; Milan: pp. 258–276. 2010
3.	Søgaard KK, Cronin-Fenton DP, Pedersen L, Sørensen HT and Lash TL: Survival in Danish patients with breast cancer and inflammatory bowel disease: a nationwide cohort study. Inflamm Bowel Dis. 14:519–525. 2008.PubMed/NCBI
4.	Louwman WJ, Voogd AC, van Dijck JA, Nieuwenhuijzen GA, Ribot J, Pruijt JF and Coebergh JW: On the rising trends of incidence and prognosis for breast cancer patients diagnosed 1975–2004: a long-term population-based study in southeastern Netherlands. Cancer Causes Control. 19:97–106. 2008.
5.	Coleman RE and Rubens RD: The clinical course of bone metastases from breast cancer. Br J Cancer. 55:61–66. 1987. View Article : Google Scholar : PubMed/NCBI
6.	Chambers AF, Groom AC and MacDonald IC: Dissemination and growth of cancer cells in metastatic sites. Nat Rev Cancer. 2:563–572. 2002. View Article : Google Scholar : PubMed/NCBI
7.	Blanco MA and Kang Y: Signaling pathways in breast cancer metastasis - novel insights from functional genomics. Breast Cancer Res. 13:2062011. View Article : Google Scholar : PubMed/NCBI
8.	Fidler IJ: The pathogenesis of cancer metastasis: the ‘seed and soil’ hypothesis revisited. Nat Rev Cancer. 3:453–458. 2003.
9.	Kang Y: New tricks against an old foe: molecular dissection of metastasis tissue tropism in breast cancer. Breast Dis. 26:129–138. 2007.PubMed/NCBI
10.	Buijs JT and van der Pluijm G: Osteotropic cancers: from primary tumor to bone. Cancer Lett. 273:177–193. 2009. View Article : Google Scholar : PubMed/NCBI
11.	Sethi N and Kang Y: Unravelling the complexity of metastasis - molecular understanding and targeted therapies. Nat Rev Cancer. 11:735–748. 2011. View Article : Google Scholar : PubMed/NCBI
12.	Santini D, Schiavon G, Vincenzi B, et al: Receptor activator of NF-κB (RANK) expression in primary tumors associates with bone metastasis occurrence in breast cancer patients. PLoS One. 6:e192342011.
13.	Ibrahim T, Sacanna E, Gaudio M, et al: Role of RANK, RANKL, OPG, and CXCR4 tissue markers in predicting bone metastases in breast cancer patients. Clin Breast Cancer. 11:369–375. 2011. View Article : Google Scholar : PubMed/NCBI
14.	Virk MS and Lieberman JR: Tumor metastasis to bone. Arthritis Res Ther. 9(Suppl 1): S52007. View Article : Google Scholar
15.	Boyle WJ, Simonet WS and Lacey DL: Osteoclast differentiation and activation. Nature. 423:337–342. 2003. View Article : Google Scholar : PubMed/NCBI
16.	Roodman GD: Mechanisms of bone metastasis. N Engl J Med. 350:1655–1664. 2004. View Article : Google Scholar : PubMed/NCBI
17.	Weinfurt KP, Li Y, Castel LD, Saad F, et al: The significance of skeletal-related events for the health-related quality of life of patients with metastatic prostate cancer. Ann Oncol. 16:579–584. 2005. View Article : Google Scholar
18.	Saad F, Lipton A, Cook R, Chen YM, Smith M and Coleman R: Pathologic fractures correlate with reduced survival in patients with malignant bone disease. Cancer. 110:1860–1867. 2007. View Article : Google Scholar : PubMed/NCBI
19.	Delea T, McKiernan J, Brandman J, et al: Retrospective study of the effect of skeletal complications on total medical care costs in patients with bone metastases of breast cancer seen in typical clinical practice. J Support Oncol. 4:341–347. 2006.
20.	Jensen AØ, Jacobsen JB, Nørgaard M, Yong M, Fryzek JP and Sørensen HT: Incidence of bone metastases and skeletal-related events in breast cancer patients: a population-based cohort study in Denmark. BMC Cancer. 11:292011.
21.	Dent R, Hanna WM, Trudeau M, Rawlinson E, Sun P and Narod SA: Pattern of metastatic spread in triple-negative breast cancer. Breast Cancer Res Treat. 115:423–428. 2009. View Article : Google Scholar : PubMed/NCBI
22.	Hortobagyi GN, Theriault RL, Lipton A, et al: Long-term prevention of skeletal complications of metastatic breast cancer with pamidronate. Protocol 19 Aredia Breast Cancer Study Group J Clin Oncol. 16:2038–2044. 1998.PubMed/NCBI
23.	Hortobagyi GN, Theriault RL, Porter L, et al: Efficacy of pamidronate in reducing skeletal complications in patients with breast cancer and lytic bone metastases. Protocol 19 Aredia Breast Cancer Study Group N Engl J Med. 335:1785–1791. 1996.PubMed/NCBI
24.	Domchek SM, Younger J, Finkelstein DM and Seiden MV: Predictors of skeletal complications in patients with metastatic breast carcinoma. Cancer. 89:363–368. 2000. View Article : Google Scholar : PubMed/NCBI
25.	Cazzaniga ME, Dogliotti L, Cascinu S, et al: Diagnosis, management and clinical outcome of bone metastases in breast cancer patients: results from a prospective, multicenter study. Oncology. 71:374–381. 2006. View Article : Google Scholar : PubMed/NCBI
26.	Koizumi M, Yoshimoto M, Kasumi F and Ogata E: Comparison between solitary and multiple skeletal metastatic lesions of breast cancer patients. Ann Oncol. 14:1234–1240. 2003. View Article : Google Scholar : PubMed/NCBI
27.	Niikura N, Liu J, Hayashi N, et al: Treatment outcome and prognostic factors for patients with bone-only metastases of breast cancer: a single-institution retrospective analysis. Oncologist. 16:155–164. 2011. View Article : Google Scholar : PubMed/NCBI
28.	Johnston SR: The role of chemotherapy and targeted agents in patients with metastatic breast cancer. Eur J Cancer. 47(Suppl 3): S38–S47. 2011. View Article : Google Scholar : PubMed/NCBI
29.	Cruz Jurado J, Richart Aznar P, García Mata J, et al: Management of patients with metastatic breast cancer. Adv Ther. 28(Suppl 6): 50–65. 2011.
30.	El Saghir NS, Tfayli A, Hatoum HA, Nachef Z, Dinh P and Awada A: Treatment of metastatic breast cancer: state-of-the-art, subtypes and perspectives. Crit Rev Oncol Hematol. 80:433–449. 2011.
31.	Lipton A: Implications of bone metastases and the benefits of bone-targeted therapy. Semin Oncol. 37(Suppl 2): S15–S29. 2010. View Article : Google Scholar : PubMed/NCBI
32.	Pagani O, Senkus E, Wood W, et al ESO-MBC Task Force: International guidelines for management of metastatic breast cancer: can metastatic breast cancer be cured? J Natl Cancer Inst. 102:456–463. 2010. View Article : Google Scholar : PubMed/NCBI
33.	Amadori A, Cascinu S, Conte PF and Ibrahim T: Osteo-oncology Textbook. Poletto Editore; Milan: pp. 5862010
34.	Ibrahim T, Flamini E, Fabbri L, et al: Multidisciplinary approach to the treatment of bone metastases: Osteo-Oncology Center, a new organizational model. Tumori. 95:291–297. 2009.PubMed/NCBI