Usefulness of bone formation markers in breast cancer.
The skeleton is the main site affected by metastases and breast cancer is the most frequent tumor to invade bone. The assessment of bone metastases is difficult and biochemical markers of bone formation (BFMs) could be a promising alternative. Although the essential role of osteoblasts in the metastatic process of bone destruction is now well established, little attention has been paid to BFMs. We conducted a Medline search for studies about BFMs in breast cancer. Our review allows us to conclude that BFMs have high specificity but low sensitivity for the diagnosis of bone metastases. The available biochemical markers cannot replace imaging techniques for the diagnosis of bone metastases. Several studies indicate that BFM serum levels reflect total tumor burden in the skeleton. BFM levels are higher in patients with blastic lesions compared to those with lytic lesions. Serial measurements of BFMs could be useful for the clinical assessment of response to antineoplastic treatment or to bisphosphonate therapy. Besides markers of bone resorption, biochemical markers of bone formation are a promising alternative for the assessment of metastatic bone disease, but large prospective studies are needed to address this important issue.
Palma
M A
MA
Unit of Endocrinology and Bone Diseases, Department of Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Body
J J
JJ
D000469:Alkaline Phosphatase / Q000097:blood; D014408:Biomarkers, Tumor / Q000032:analysis*; D001859:Bone Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D001862:Bone Resorption / Q000175:diagnosis; D001842:Bone and Bones / Q000201:enzymology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D002352:Carrier Proteins / Q000032:analysis; D003131:Combined Modality Therapy; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008562:Membrane Glycoproteins / Q000032:analysis; D010006:Osteoblasts / Q000473:pathology; D015675:Osteocalcin / Q000032:analysis; D010012:Osteogenesis / Q000502:physiology*; D010014:Osteolysis / Q000473:pathology; D053244:Osteoprotegerin; D010446:Peptide Fragments / Q000032:analysis; D011347:Procollagen / Q000032:analysis; D011379:Prognosis; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D018160:Receptors, Cytoplasmic and Nuclear / Q000032:analysis; D018124:Receptors, Tumor Necrosis Factor / Q000032:analysis; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D002352:Carrier Proteins; D004164:Diphosphonates; D006023:Glycoproteins; D007527:Isoenzymes; D008562:Membrane Glycoproteins; D053244:Osteoprotegerin; D010446:Peptide Fragments; D011347:Procollagen; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C505686:TNFRSF11A protein, human; C506030:TNFRSF11B protein, human; C505688:TNFSF11 protein, human; C047202:procollagen Type I N-terminal peptide; C042813:procollagen type I carboxy terminal peptide; D015675:Osteocalcin; D000469:Alkaline Phosphatase