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Metastatic tumours of the bone are the most common types of bone cancer. Autopsy studies have shown that 70% of patients with breast and prostate carcinoma develop skeletal metastases. The most commonly involved bone sites are those with persistent red marrow, such as the vertebrae, proximal femur, ribs, sternum, pelvis and skull. The precise mechanism of metastases to bone is unclear, however, the understanding of the molecular biology of metastases is becoming increasingly important in providing new therapeutic targets. Treatment of bone metastases is multi-modal and may include medications, radiotherapy or surgery. Bone metastases can cause many complications and have significant morbidity. Traditionally, the presence of a metastatic bone deposit has been seen as a terminal event. With the increased survival and improved treatment of patients with carcinoma, long-term survival with metastatic bone disease is possible and treatment can prolong life, or even be curative. Implants used in reconstruction need to be sufficiently robust to survive the patient, and the expertise of reconstruction available within tertiary bone tumour units is increasingly required.

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