Bone metastasis risk factors in breast cancer

Abstract

Bone is the single most frequent site for bone metastasis in breast cancer patients. Patients with bone-only metastasis have a fairly good prognosis when compared with patients with visceral disease. Nevertheless, cancer-induced bone disease carries an important risk of developing skeletal related events that impact quality of life (QoL). It is therefore particularly important to stratify patients according to their risk of developing bone metastasis. In this context, several risk factors have been studied, including demographic, clinicopathological, genetic, and metabolic factors. Most of them show conflicting or non-definitive associations and are not validated for clinical use. Nonetheless, tumour intrinsic subtype is widely accepted as a major risk factor for bone metastasis development and luminal breast cancer carries an increased risk for bone disease. Other factors such as gene signatures, expression of specific cytokines (such as bone sialoprotein and bone morphogenetic protein 7) or components of the extracellular matrix (like bone crosslinked C-telopeptide) might also influence the development of bone metastasis. Knowledge of risk factors related with bone disease is of paramount importance as it might be a prediction tool for triggering the use of targeted agents and allow for better patient selection for future clinical trials.

Comparison of diagnostic validity between mitotic activity index and Ki-67 expression as predictor for breast cancer in distant metastasis

“…With this result, it doesn't relate to a study conducted by Pulido and associates, where they stated that bone was the most common distant metastasis target organ found in breast cancer patients. 16 Similar outcome also presented from a study conducted by Chen, stating that bone was the most common distant metastases target organ in breast cancer patients. 17 Our study showed several patients, particularly patient aged 40 years and above suffered distant metastasis for more than one target organ.…”

Optimizing Quality of Life in Patients with Hormone Receptor-Positive Metastatic Breast Cancer: Treatment Options and Considerations

“…Patients with bone as a single metastatic site demonstrate a better prognosis than those with visceral or both bone and visceral disease [49] . Visceral metastases, those occurring in the soft internal organs of the body, including the lungs, heart, and organs of the digestive, excretory, reproductive, and circulatory systems, portend a poor prognosis [2,50] .…”

Current status and future directions in the treatment of bone metastases from breast cancer

“…For this purpose, emerging studies have highlighted a significant association between molecular subtype of BCawhich reflect phenotypic and genotypic variations of the biology of this tumour, and risk of bone metastasis. 29,30 For instance, some of these studies have shown that patients with Luminal A type BCa were prone to metastasizing to the bone rather than to other anatomical sites. 30 Furthermore, hormone receptor (HR + )/human epidermal growth factor receptor (HER2 + )(HR + /HER2 + ) subtype significantly correlated with an elevated risk of bone metastasis.…”

“…30 Conversely, patients with a triple-negative subtype (TNBC) were, most likely to develop visceral metastases rather than bone metastasis. 29,30 On the other hand, the use of multi-OMICS integrative approaches has greatly facilitated the identification of a growing number of molecular candidates which appear to be promising as potential diagnostic and prognostic biomarkers to identify BCa patients at high risk of developing bone metastasis. 13,22,29 In summary, the currently available clinical approach to patients with BCa-related bone disease is mostly palliative.…”