Expressiveness of Bone Markers in Breast Cancer with Bone Metastases

Oncology. 2019;97(4):236-244. doi: 10.1159/000500675. Epub 2019 Aug 14.

Abstract

Introduction: On a global scale, the malignant growth of mammary gland is the most common type of cancer in women. In the progress of mammary carcinoma, osseous metastatic invasion has a pivotal significance because it is a frequent complication occurring at an early stage of the disease.

Background: Bone metastases in breast cancer patients lead to increased mortality and decreased health-related quality of life. Therefore, early diagnostic assessment and treatment is requested. Meanwhile the progress of the disease should be monitored closely. Regarding health-related quality of life and lifetime prolongation, osseous metastases should be early diagnosed, therapied, and monitored. Up to date the gold standard is the whole-body scintigraphy. This kind of bone imaging features has high sensitivity but shows loss of specificity.

Aim: This study aims to investigate the diagnostic versatility of bone markers in its resorption and formation function to detect bone metastases in patients with breast cancer.

Patients, materials, and methods: For this purpose, the concentration of competing bone processing tumor markers in serums of 78 patients was detected and analyzed. Two groups of women with mammary carcinoma with and without osseous metastases were built to examine the presence (or absence) of statistically significant disparity of tumor marker concentration. The tumor markers employed in this study were the carboxyterminal collagen type I telopeptid (CTX), known as beta-crosslaps (β-CTx), the alkaline phosphatase (AP), and its isoenzymes (especially the bone-specific AP [B-AP]). Additionally, the tumor markers for breast cancer (CA 15-3 and CEA) were analyzed in both groups.

Results: Our results provide evidence that in both groups, tumor markers such as β-CTx and B-AP were a promising tool for the detection and exclusion of bone metastases in breast cancer. This comprehensive investigation shows both β-CTx and B-AP are able to fulfill the conditions of a competent appliance to detect osseous metastases of patients with mammary carcinoma.

Conclusion: Concerning the urgency of early and frequent detection, staging, and disease monitoring of mammary carcinoma with osseous metastases, this study renewed and underlined the importance of biochemical tumor markers - especially β-CTx and B-AP - and laid a clinical-based cornerstone to build up on a prospective research.

Keywords: Alkaline phosphatase; Beta-crosslaps; Bone marker; Bone metastases; Bone-specific alkaline phosphatase; Breast cancer; Tumor marker.

MeSH terms

  • Alkaline Phosphatase / metabolism
  • Biomarkers / metabolism*
  • Biomarkers, Tumor
  • Bone Neoplasms / metabolism*
  • Bone Neoplasms / secondary
  • Bone and Bones / metabolism*
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / pathology
  • Collagen Type I / metabolism
  • Female
  • Humans
  • Mucin-1 / metabolism
  • Neoplasm Metastasis
  • Quality of Life
  • ROC Curve
  • Radionuclide Imaging
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Whole Body Imaging

Substances

  • Biomarkers
  • Biomarkers, Tumor
  • Collagen Type I
  • Mucin-1
  • Alkaline Phosphatase