title: Assessing response to treatment of bone metastases from breast cancer: what should be the standard of care?
abstract: Bone is the most common site for breast cancer metastases, occurring in up to 70% of those with metastatic disease. In order to effectively manage these patients, it is essential to have consistent, reproducible and validated methods of assessing response to therapy. We present current clinical practice of imaging response assessment of bone metastases. We also review the biology of bone metastases and measures of response assessment including clinical assessment, tumour markers and imaging techniques; bone scans (BSs), computed tomography (CT), positron emission tomography, magnetic resonance imaging (MRI) and whole-body diffusion-weighted MRI (WB DW-MRI). The current standard of care of BSs and CT has significant limitations and are not routinely recommended for the purpose of response assessment in the bones. WB DW-MRI has the potential to address this unmet need and should be evaluated in clinical trials.
authors.affiliation: Breast Cancer Research Unit, Mount Vernon Cancer Centre, Northwood. Electronic address: dwoolf@doctors.org.uk.
authors.forename: D K
authors.initials: DK
authors.lastname: Woolf
authors.affiliation: Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, UK.
authors.forename: A R
authors.initials: AR
authors.lastname: Padhani
authors.affiliation: Breast Cancer Research Unit, Mount Vernon Cancer Centre, Northwood.
authors.forename: A
authors.initials: A
authors.lastname: Makris
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D001859:Bone Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D001943:Breast Neoplasms / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods / Q000592:standards*; D038524:Diffusion Magnetic Resonance Imaging / Q000592:standards; D005260:Female; D006801:Humans; D008495:Medical Oncology / Q000592:standards*; D064847:Multimodal Imaging / Q000592:standards; D049268:Positron-Emission Tomography / Q000592:standards; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011237:Predictive Value of Tests; D059039:Standard of Care; D014057:Tomography, X-Ray Computed / Q000592:standards; D016896:Treatment Outcome; D051598:Whole Body Imaging / Q000592:standards
chemical_list: D014408:Biomarkers, Tumor
keywords: bone metastases; breast cancer; diffusion MRI; therapy monitoring; whole-body MRI