Mechanisms in the skeletal complications of breast cancer.
Breast cancer is the most common malignancy in women, with a worldwide prevalence of 1.5 million throughout the industrialized countries. Its mortality rate is second only to lung cancer in the USA and Europe. Its high incidence and prevalence makes it a major public health problem. Up to one-third of women with early stage breast cancer will eventually succumb to the disease, and most of these will develop bone metastases during the course of the disease. Approximately 70% of patients with breast cancer have bone metastases, with 27% having lung and liver metastases. Hypercalcemia also is very common in advanced breast cancer, manifesting itself in one-third of patients late in the disease. Breast cancer accounts for approximately 25% of the cases of hypercalcemia in cancer. The major skeletal complications of breast cancer--hypercalcemia and bone metastases--almost certainly share certain mechanisms and these will be discussed.
Martin
T J
TJ
St Vincent's Institute of Medical Research and The University of Melbourne Department of Medicine, St Vincent's Hospital, Fitzroy, Victoria 3065, Australia. j.martin@medicine.unimelb.edu.au
Moseley
J M
JM
D001859:Bone Neoplasms / Q000209:etiology* / Q000378:metabolism / Q000556:secondary; D001943:Breast Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D020782:Matrix Metalloproteinases / Q000378:metabolism; D010010:Osteoclasts / Q000502:physiology; D044162:Parathyroid Hormone-Related Protein; D011453:Prostaglandins / Q000378:metabolism; D011506:Proteins / Q000235:genetics / Q000378:metabolism
D016207:Cytokines; C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D011453:Prostaglandins; D011506:Proteins; D020782:Matrix Metalloproteinases