Bone Metastasis of Breast Cancer: Molecular Mechanisms and Therapeutic Strategies

Abstract

Bone metastasis is a common complication of many types of advanced cancer, including breast cancer. Bone metastasis may cause severe pain, fractures, and hypercalcemia, rendering clinical management challenging and substantially reducing the quality of life and overall survival (OS) time of breast cancer patients. Studies have revealed that bone metastasis is related to interactions between tumor cells and the bone microenvironment, and involves complex molecular biological mechanisms, including colonization, osteolytic destruction, and an immunosuppressive bone microenvironment. Agents inhibiting bone metastasis (such as bisphosphate and denosumab) alleviate bone destruction and improve the quality of life of breast cancer patients with bone metastasis. However, the prognosis of these patients remains poor, and the specific biological mechanism of bone metastasis is incompletely understood. Additional basic and clinical studies are urgently needed, to further explore the mechanism of bone metastasis and develop new therapeutic drugs. This review presents a summary of the molecular mechanisms and therapeutic strategies of bone metastasis of breast cancer, aiming to improve the quality of life and prognosis of breast cancer patients and provide a reference for future research directions.

UDP-6-glucose dehydrogenase in hormonally responsive breast cancers

“…Approximately 70% of advanced breast cancer patients develop bone metastasis with the spine being the most common site 20,21 and recent studies indicate that breast cancer has a metastatic tropism to the spinal vertebral body 22 . To determine whether our findings could translate to a human breast cancer patient, single-cell RNA-sequencing of clinical specimens obtained from a radiologically normal and tumor-containing vertebral body ( Fig.…”

Clinical practice guidelines for full‐cycle standardized management of bone health in breast cancer patients

“…A 12-year cohort study in South Korea showed that the cumulative incidence of SRE in breast cancer patients was 47% [70]. Bone pain is the most common SRE, occurring in 80% of patients with bone metastases [65,71]. Hypercalcemia is the most lethal SRE and is associated with poor prognosis; it occurs in 10%-30% of patients with osteolytic lesions [72].…”

Molecular imaging of bone metastasis

“…There is an unambiguous negative correlation between bone metastasis and survival [ 6 ]; necessitating efficient methods to detect bone metastasis in a timely manner. Advancements in molecular imaging approaches has improved accuracy of diagnosis, staging and therapy response [ [7] , [8] , [9] ]. Clinical imaging of bone, including the bone marrow utilizes a spectrum of imaging modalities such as: X-ray based radiological planar and tomographic (computed tomography (CT)) imaging, high-spatial resolution magnetic resonance imaging (MRI), and nuclear imaging (single-photon emission computed tomography (SPECT) and positron emission tomography (PET)).…”