Abstract:
Until recently, among any cancer in women, breast cancer has the highest prevalence and incidence. Bone metastasis is more common than visceral metastasis in breast cancer. Patients with bone metastasis have better overall survival but consume high cost for treatment. Because of that, tumor markers which could act as an early predictor for bone metastasis are needed so early intervention could be given efficiently and increase patient’s quality of life. CXCR4 and RANK have been known for it’s role in cancer cell homing to bone. Instead of other biomarkers of bone metastasis, CXCR4 and RANK act in the early cascade of bone metastasis process. CXCR4/SDF-1 axis plays a great role in cell trafficking of many types of human stem cell. RANK/RANKL/OPG axis mediates osteoclastogenesis and bone resorption. In several studies, CXCR4 and RANK are highly expressed in breast cancer and correlate with bone metastasis. In an observational analytic cross sectional study, CXCR4 and RANK immunohistochemistry were done to 58 breast cancer samples from stage I-IV. Correlation with metastasis, menopausal status, cancer stadium, lymph node involvement, hormonal receptor and HER-2 amplification were analyzed. Combination of highly expressed CXCR4 and highly expressed RANK had significant correlation with bone metastasis (p<0.01). Breast cancer’s stadium had significant correlation with combined CXCR4 and RANK expression (p<0.01). Combination of CXCR4 expression and RANK expression could act as a predictor for bone metastasis in breast cancer. Early detection of bone metastasis will have a great implication in patient’s quality of life and treatment cost
