Evidence of increased bone turnover in breast cancer patients with bone metastases in a retrospective study

This retrospective study involved an analysis of available data on tumour m arkers and bone markers of 28 patients with clinical evidence of breast can cer metastases. This included one or more sets of data on tumour markers (C EA, CA15-3, MCA), bone formation markers (total and bone alkaline phosphata se, osteocalcin, procollagen), and bone resorption markers (telopeptide, py ridinolines). The data on bone markers were compared with those obtained fr om breast cancer patients without metastases and normal women of the same a ge range. in patients with bone metastases approximately 80% of the values on tumour markers (CEA, CA15-3) and between 16-96% of the values on bone ma rkers were elevated, predominantly bone resorption markers. Bone resorption was also significantly higher than in breast cancer patients without metas tases than in normal women, as assessed by telopeptide and both telopeptide and pyridinolines, respectively. Statistically significant positive correl ations between tumour markers (CEA, CA15-3) and bone resorption markers ind icated that bone destruction was the main bone action in the metastatic dis ease. Correlations between bone markers were positive, revealing involvemen t of both formation and resorption processes in the metastatic spread of br east carcinoma to the skeleton. Correspondingly, in a small sample a positi ve correlation of CEA and MCA with bone formation indicator procollagen was found. These results showed increased bone turnover with prevailing bone r esorption in breast cancer patients with bone metastases. Bone resorption w as higher than in breast cancer patients without metastases and normal wome n of the same age range. In addition, bone destruction might be related to the extent of malignant disease.