Tumour progression and angiogenesis in bone metastasis from breast cancer:new approaches to an old problem

Breast cancer metastasizes frequently to the skeleton and causes considerab le morbidity and deterioration of the quality of life. The clinical consequ ences of skeletal metastases are bone pain, pathological fractures. hyperca lcaemia and nerve compression syndromes. From the moment breast cancer cell s are located in the bone microenvironment, they may release factors which stimulate bone resorption and angiogenesis leading to growth of skeletal me tastases and a subsequent selective increase in the attraction of new cance r cells to bone. In this review. emerging new concepts of breast cancer-bone interactions. i n particular the involvement of angiogenesis, proteolysis and the role of c ancer-induced bone resorption in skeletal metastasis are discussed. Better understanding of the processes involved in the metastasis of cancer cells t o bone, local tumour growth and subsequent destruction of skeletal architec ture can lead to optimal methods for the prevention and treatment of metast atic bone disease. (C) 2000 Harcourt Publishers Ltd.