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Will My Breast Cancer Spread to My Bones?

A diagnosis of breast cancer triggers a cascade of worries. “Am I going to die?” is surely the most terrifying. A close second for many patients is fear of pain, particularly if cancer metastasizes (spreads) to the bones. Bone mets can cause agonizing pain in several ways. A sudden break in a weakened bone can bring unexpected pain, and tumor growth affects nerves in and around the bone.

Many breast cancer patients are concerned about developing bone mets, especially since bone is a location that BCa cells commonly spread to. One way that researchers calculate this likelihood is by pooling data from previously published work. The more the studies, the more reliable the statistical results.

A 2017 literature review identified 156 breast cancer studies in which a percentage of women in each were diagnosed with bone mets either at the start of the study or during follow-upi. Here are key points:

  • 58% of patients who were initially diagnosed as already having metastatic disease (Stage IV) had bone mets. It is not surprising that more than half of women whose BCa has spread beyond the breast and lymph nodes at the time they are diagnosed already have bone mets, since bone is a preferred breast cancer location for spread.
  • Of patients who developed metastatic disease to any location during follow-up, an average of just over half (55%) had bone mets. This, too, is not unexpected – again because of the preferential spread to bone.

These first two statistics sound alarming, but keep in mind that what they are saying is that if BCa manages to spread to more remote locations, there’s a strong likelihood that bone will be one of the locations. However, the overall average offers much more hope:

  • An average of 12% of women initially diagnosed with Stage I-III disease developed bone mets during 60 months (5 years) of follow up.

12% is more reassuring. It reflects a total population pooled across all stages (Stage I-IV). This lowers the probability considerably because earlier stage cases are included. Looked at another way, Stage I patients have 99% survival at 5 years, and Stage IIB patients have 85% at 5 years. In other words, only a minority of BCa patients are likely to have bone mets. Of course, each patient’s clinical factors at diagnosis will affect probability, but the numbers are favorably, particularly with early diagnosis.

For bone mets patients who experience pain that is not controllable by medication or treatments like radiation, the Sperling Medical Group offers MR-guided Focused Ultrasound (MRgFUS), a noninvasive outpatient treatment that can destroy bone tumors and the nerves that send pain messages – while preserving healthy tissue. For more information, contact the Sperling Medical Group.

iBody 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.

Bone mets