Osteooncology - Specific Aspects in Breast Cancer Patients

摘要

Affecting a greater number of patients than any other meta-static location, tumor metastasis to bone has a substantial impact on cancer patients' morbidity and mortality, including those with breast and some other solid tumors which are particularly prone to such skeletal disease. Bone metastasis occurs in approximately 70% of women with advanced breast malignancies, bone health thus gaining in relevance as a most critical issue in breast cancer management. While systemic treatment for breast cancer will act to decrease circulating levels of estrogen at any age - further accelerating the natural decline of bone - many women who develop breast disease are postmenopausal and thus already predisposed to osteoporosis. Studies in the bone microenvironment and its role in metastasis have recently revealed its complex role in tumor growth. Accelerated or cancer treatment-induced bone loss (CTIBL) is a common clinical feature that has been shown to lead to a critical increase in fractures, chronic pain, loss of mobility and other complications. Fortunately, both pre-clinical and clinical research in the potential of adjuvant bone-targeted agents in preventing metastasis and avoiding CTIBL have so far yielded promising results. The potential role of bone-targeted agents is underscored by emerging data from large clinical trials suggesting that additional anticancer benefits can be accomplished due to a positive impact on the bone marrow microenvironment.