title: The Breast Cancer to Bone (B2B) Metastases Research Program: a multi-disciplinary investigation of bone metastases from breast cancer.
abstract: BACKGROUND
  Bone is the most common site of breast cancer distant metastasis, affecting 50-70 % of patients who develop metastatic disease. Despite decades of informative research, the effective prevention, prediction and treatment of these lesions remains elusive. The Breast Cancer to Bone (B2B) Metastases Research Program consists of a prospective cohort of incident breast cancer patients and four sub-projects that are investigating priority areas in breast cancer bone metastases. These include the impact of lifestyle factors and inflammation on risk of bone metastases, the gene expression features of the primary tumour, the potential role for metabolomics in early detection of bone metastatic disease and the signalling pathways that drive the metastatic lesions in the bone.
  
  
  METHODS
  The B2B Research Program is enrolling a prospective cohort of 600 newly diagnosed, incident, stage I-IIIc breast cancer survivors in Alberta, Canada over a five year period. At baseline, pre-treatment/surgery blood samples are collected and detailed epidemiologic data is collected by in-person interview and self-administered questionnaires. Additional self-administered questionnaires and blood samples are completed at specified follow-up intervals (24, 48 and 72 months). Vital status is obtained prior to each follow-up through record linkages with the Alberta Cancer Registry. Recurrences are identified through medical chart abstractions. Each of the four projects applies specific methods and analyses to assess the impact of serum vitamin D and cytokine concentrations, tumour transcript and protein expression, serum metabolomic profiles and in vitro cell signalling on breast cancer bone metastases.
  
  
  CONCLUSIONS
  The B2B Research Program will address key issues in breast cancer bone metastases including the association between lifestyle factors (particularly a comprehensive assessment of vitamin D status) inflammation and bone metastases, the significance or primary tumour gene expression in tissue tropism, the potential of metabolomic profiles for risk assessment and early detection and the signalling pathways controlling the metastatic tumour microenvironment. There is substantial synergy between the four projects and it is hoped that this integrated program of research will advance our understanding of key aspects of bone metastases from breast cancer to improve the prevention, prediction, detection, and treatment of these lesions.
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 515C, Holy Cross Centre, 2210 2nd St, SW, Calgary, AB, T2S 3C3, Canada. nigel.brockton@albertahealthservices.ca.|Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. nigel.brockton@albertahealthservices.ca.
authors.forename: Nigel T
authors.initials: NT
authors.lastname: Brockton
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 515C, Holy Cross Centre, 2210 2nd St, SW, Calgary, AB, T2S 3C3, Canada.|Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Gill
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 515C, Holy Cross Centre, 2210 2nd St, SW, Calgary, AB, T2S 3C3, Canada.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Laborge
authors.affiliation: Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Division of Medical Oncology, Tom Baker Cancer Centre, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Alexander H G
authors.initials: AH
authors.lastname: Paterson
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 515C, Holy Cross Centre, 2210 2nd St, SW, Calgary, AB, T2S 3C3, Canada.|Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Cook
authors.affiliation: Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Vogel
authors.affiliation: Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Carrie S
authors.initials: CS
authors.lastname: Shemanko
authors.affiliation: Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: David A
authors.initials: DA
authors.lastname: Hanley
authors.affiliation: Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Magliocco
authors.affiliation: Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 515C, Holy Cross Centre, 2210 2nd St, SW, Calgary, AB, T2S 3C3, Canada.|Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Friedenreich
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D001859:Bone Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000556:secondary*; D001943:Breast Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology*; D016207:Cytokines / Q000097:blood; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D011446:Prospective Studies; D012107:Research Design; D016019:Survival Analysis; D014807:Vitamin D / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; D016207:Cytokines; D014807:Vitamin D