ABSTRACT
According to one series, 30% to 90% of patients with advanced cancer will develop skeletal metastases. Carcinomas of the breast (47%–85%), of the prostate (33%–85%), and of the lung (32%–60%) are the tumors most commonly associated with skeletal metastases, whereas tumors of the digestive tract are only rarely (3%–13%) complicated by metastatic involvement of bone (1). The skeleton is the most common site of metastatic disease in breast cancer and the most common site of first distant relapse (2,3). These patients have a relatively long survival time after the diagnosis of bone metastases compared to patients with extraosseous metastases. Their median survival is usually beyond 20 months and about 10% of these patients are still alive 5 to 10 years after the first diagnosis of bone metastases (2). Osteolytic bone disease can thus be responsible for considerable morbidity and can markedly decrease the quality of life (Table 1) (2-5). Because of the long clinical course that breast cancer may follow, morbidity from bone metastases makes major demands on resources for health care provision. Major complications are seen in up to one-third of the patients whose first relapse is in bone (2,5).
