Franco Lumachi1, Stefano M M Basso2, Valentina Camozzi3, Renato Tozzoli4, Roberto Spaziante5, Mario Ermani6. 1. Department of Surgery, Oncology & Gastroenterology (DiSCOG), University of Padua, School of Medicine, 35128 Padova, Italy. Electronic address: flumachi@unipd.it. 2. Department of Surgery, General Surgery, S. Maria degli Angeli Hospital, 33170 Pordenone, Italy. 3. Department of Medicine (DiMed), University of Padua, School of Medicine, 35128 Padova, Italy. 4. Department of Laboratory Medicine, Clinical Pathology Laboratory, S. Maria degli Angeli Hospital, 33170 Pordenone, Italy. 5. Department of Diagnostic Imaging, Nuclear Medicine Section, S. Maria degli Angeli Hospital, 33170 Pordenone, Italy. 6. Department of Neurosciences (DNS), University of Padua, School of Medicine, 35128 Padova, Italy.
Abstract
BACKGROUND: The skeleton is the most common site of metastasis for breast cancer and the periodic measurement of circulating bone turnover markers (BTMs) can be useful. The aim of this study was to prospectively evaluate the diagnostic accuracy of a panel of BTMs in the early detection of bone metastases (BMs). METHODS: We reviewed the medical records of 297 postmenopausal women with early stage luminal-type invasive ductal carcinoma (IDC). Twenty-six patients who developed isolated BMs during follow-up and 24 randomly selected controls were studied. The two groups were matched according to age, final disease staging, and follow-up. All patients underwent periodic measurement of total and bone-specific (BSAP) alkaline phosphatase, CTX, ICTP, osteocalcin, NTX, PINP, and TRACP5b. RESULTS: Only BSAP, CTX, PINP, and TRACP5b were significantly (p<0.05) associated with the group, and the logistic regression analysis excluded CTX from the model. The AUC (ROC curve) for TRACP5b alone, which was the most accurate marker, and for the combination of BSAP+PINP+TRACP5b was 0.784 (95% CI: 0.651-0.916) and 0.889 (95% CI: 0.798-0.981), respectively. CONCLUSION: According to our results, the measurement of these three markers together should be performed in all postmenopausal patients with luminal-type IDC, when an early diagnosis of BMs is required.
BACKGROUND: The skeleton is the most common site of metastasis for breast cancer and the periodic measurement of circulating bone turnover markers (BTMs) can be useful. The aim of this study was to prospectively evaluate the diagnostic accuracy of a panel of BTMs in the early detection of bone metastases (BMs). METHODS: We reviewed the medical records of 297 postmenopausal women with early stage luminal-type invasive ductal carcinoma (IDC). Twenty-six patients who developed isolated BMs during follow-up and 24 randomly selected controls were studied. The two groups were matched according to age, final disease staging, and follow-up. All patients underwent periodic measurement of total and bone-specific (BSAP) alkaline phosphatase, CTX, ICTP, osteocalcin, NTX, PINP, and TRACP5b. RESULTS: Only BSAP, CTX, PINP, and TRACP5b were significantly (p<0.05) associated with the group, and the logistic regression analysis excluded CTX from the model. The AUC (ROC curve) for TRACP5b alone, which was the most accurate marker, and for the combination of BSAP+PINP+TRACP5b was 0.784 (95% CI: 0.651-0.916) and 0.889 (95% CI: 0.798-0.981), respectively. CONCLUSION: According to our results, the measurement of these three markers together should be performed in all postmenopausal patients with luminal-type IDC, when an early diagnosis of BMs is required.