A New Treatment for Painful Bone Mets from Breast Cancer

How breast cancer spreads

A diagnosis of breast cancer starts a chain of research, further tests, and anxiety. Although mortality rates have gradually been dropping, an understandable worry is the fear of the disease having spread microscopically at the time of diagnosis.

Thankfully, screening programs work, and most breast cancer is detected early when it is highly curable. However, if left untreated, breast cancer can metastasize (spread). Most commonly, it travels first to the lymph nodes in the armpit area. Once it enters the lymphatic system, it can spread to other areas of the body, including organs and bones. Also, some types of breast cancer can enter the bloodstream, using the circulatory system to spread to other areas.

Breast cancer that spreads to the bone (bone mets) is particularly feared, since weakened bones and severe bone pain can literally become crippling. However, the odds are greater than 80% against developing bone mets. According to one analysis, an average of 12% of women initially diagnosed with Stage I-III disease developed bone mets during 60 months (5 years) of follow up.¹

Bone mets from breast cancer

When breast cancer has spread to the bone or other organs, it is called Stage IV disease. Even though tumors are growing elsewhere, they are still breast cancer cells that are forming the tumors. Therefore, systemic (whole-body) treatments such as chemotherapy or immunotherapy are used in an effort to eradicate the breast cancer wherever it exists in the body.

At the same time, if the metastatic tumor location presents a problem, the patient’s medical team will also prioritize addressing it for two main reasons:

1. Treating or destroying the local tumor (e.g. in the bone or lung) lessens the cancer’s burden on the body, potentially helping systemic therapies do their job, and
2. Improving quality of life for the patient by controlling pain and other symptoms.

The first symptom of bone mets is often bone pain. Other symptoms include bone fractures, and elevated blood levels of calcium as the cancerous tumors in the bone break the bone down which releases calcium into the bloodstream. While pain medication may relieve pain, it does not halt the local tumor activity in the bone. Currently, there are three types of local treatment for bone mets: surgery, radiation, and ablation (minimally invasive tumor destruction). The ideal approach would be one that stops the tumor activity and at the same time provide effective pain control.

A new treatment meets achieves both purposes

There is a revolutionary new noninvasive treatment to ease pain and put the brakes on local bone mets by ablating the bone tumor (lesion). It is called MR-guided Focused Ultrasound (MRgFUS).

MRgFUS begins with identification and planning. Magnetic resonance imaging reveals the location, size and extent of the lesion. This same imaging allows the physician to plan strategically targeted delivery of ultrasound (sound waves) to the lesion. The ultrasound “beams” are aimed from numerous different directions, and each one passes harmlessly through skin and other tissues. Then, when the beams converge, they generate a short blast of lethal heat at the point where they meet. This heat destroys (ablates) the bone mets at that site, and deadens the nerves that send pain messages to the brain.

Within 3-7 days, most patients have significant pain reduction – in many cases, almost none.

Advantages of MRgFUS

Breast cancer bone mets patients who are candidates for bone surgery or radiation are also candidates for MRgFUS. A brief comparison highlights the differences:

	Outpatient	Efficient	Fast recovery after treatment	Rapid pain relief	Noninvasive
Surgery	X		X	X (Though not always)
Radiation	X 5-10 sessions		X		X
MRgFUS	X	X	X	X	X

 

If you or a loved one has been diagnosed with breast cancer bone mets, the Sperling Medical Group offers state-of-the-art MRI to scan for bone mets. If there are bone mets causing pain, our Center offers the Exablate MRgFUS to relieve pain that does not respond to medication. For more information, contact our Center, or visit our website.

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Body JJ, Quinn G, Talbot S, Booth E et al. Systematic review and meta-analysis on the proportion of patients with breast cancer who develop bone metastases. Crit Rev Oncol Hematol. 2017 Jul;115-67-80.