Breast cancer and bone

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Abstract
For more than a century, it has been evident that breast cancer has deleterious effects on bone. Breast cancer can affect bone both locally and systemically via one common final pathway, the osteoclast, to cause pain, fracture, hypercalcemia, and nerve compression syndromes. Specifically, breast cancers can secrete factors, such as parathyroid hormone-related protein (PTHrP), that systemically increase osteoclastic bone resorption and renal tubular reabsorption of calcium to cause hypercalcemia. The predominant way in which breast cancer affects bone is by metastatic spread. Breast cancer displays osteotropism, an extraordinary affinity to grow in bone. Current evidence supports the concept that breast cancer cells possess certain properties that enable them to grow in bone, and the bone microenvironment provides a fertile soil on which breast cancer cells can grow. Furthermore, secretion of bone-resorbing factors, such as PTHrP, by breast cancer cells may provide a selective advantage for these cancer cells to grow in bone, and factors in the bone microenvironment, such as transforming growth factor β, may further increase this advantage by increasing PTHrP production by breast cancer cells.

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