The prognostic and predictive value of serum bone biomarker (CTX) in patients with breast cancer metastatic to bone receiving Zoledronic acid

Abstract

Breast cancer is the most common malignancy in females worldwide. In Egypt, 23, 081 female cases were diagnosed with breast cancer in 2018 with 9,254 cases of breast cancer related death. Bone is the most common site of distant metastasis as more than 58% of patients with metastatic breast cancer present with or develop bone metastasis. The increased bone resorption caused by bone metastases causes patients with breast cancer to have a high risk of skeletal complications such as pathological fractures, cord compression, bone marrow infiltration, hypercalcemia of malignancy and the need of radiotherapy or surgery to bone. Each of these complications may substantially reduce quality of life and fractures have also been associated with significantly reduced survival. Bone targeted treatments as bisphosphonates can reduce skeletal complications from malignant bone disease, and it is a standard therapy in breast cancer patients with bone metastases, whether they are symptomatic or not. (Van Poznak et al., 2017). Bone markers in serum or urine may be useful tools for diagnosing BMs, determining prognosis of bone metastatic patients and predicting skeletal-related events. It can reflect both the formation and resorption of bone and can be used as quantitative method of response evaluation if applied and interpreted correctly.