Mechanisms and pathways of bone metastasis: challenges and pitfalls of performing molecular research on patient samples

  • T. R. Cawthorn
  • E. Amir
  • R. Broom
  • O. Freedman
  • D. Gianfelice
  • D. Barth
  • D. Wang
  • I. Holen
  • S. J. Done
  • M. ClemonsEmail author
Research Paper


The molecular mechanisms underlying the development of bone metastases in breast cancer remain unclear. Disseminated tumour cells (DTCs) in the bone marrow of breast cancer patients are commonly identified, even in early stage disease, but their potential to initiate metastases is not known. The mechanism whereby DTCs become overt metastatic tumour cells (MTCs) is therefore, an area of considerable interest. This study explored the analysable yield of genetic material from human biopsy samples in order to describe differences in gene expression between DTCs and bone MTCs. Thirteen breast cancer patients with bone metastases underwent a CT-guided bone metastasis biopsy and a bone marrow biopsy. Tumour cells were enriched and gene expression profiling was conducted to identify differentially expressed genes. The analysable yield of sufficient RNA for microarray analysis was 60% from bone metastasis biopsies and 80% from bone marrow biopsies. A signature of 133 candidate genes differentially expressed between DTCs and MTCs was identified. Several genes relevant to breast cancer metastasis to bone (osteopontin, CTGF, parathyroid hormone receptor, EGFR) were significantly overexpressed in MTCs as compared to DTCs. Biopsies of bone metastases and bone marrow rarely yield enough tissue for robust molecular biology studies using clinical samples. The findings obtained however are interesting and seem to overlap with the bone metastasis gene expression signature described in murine xenograft models. Larger biopsy specimens or improved RNA extraction techniques may improve analysable yield and feasibility of these techniques.


Breast cancer Bone metastasis Disseminated tumour cells Feasibility Gene expression profiling 



Complimentary deoxyribonucleic acid


Complimentary ribonucleic acid


Computed tomography


Circulating tumour cell


Deoxyribonucleic acid


Disseminated tumour cell


Epithelial cell adhesion molecule


Messenger ribonucleic acid


Real time quantitative polymerase chain reaction


Ribonucleic acid


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • T. R. Cawthorn
    • 1
    • 2
  • E. Amir
    • 3
    • 4
  • R. Broom
    • 3
    • 4
  • O. Freedman
    • 3
    • 4
  • D. Gianfelice
    • 5
  • D. Barth
    • 6
  • D. Wang
    • 1
    • 2
  • I. Holen
    • 8
  • S. J. Done
    • 1
    • 2
    • 7
  • M. Clemons
    • 3
    • 4
    • 9
    • 10
    Email author
  1. 1.Division of Applied Molecular OncologyPrincess Margaret HospitalTorontoCanada
  2. 2.Department of Medical BiophysicsUniversity of TorontoTorontoCanada
  3. 3.Division of Medical Oncology & HaematologyPrincess Margaret HospitalTorontoCanada
  4. 4.Department of MedicineUniversity of TorontoTorontoCanada
  5. 5.Department of RadiologyToronto General HospitalTorontoCanada
  6. 6.Department of PathologyToronto General HospitalTorontoCanada
  7. 7.Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada
  8. 8.Academic Unit of Clinical OncologyUniversity of SheffieldSheffieldUK
  9. 9.Campbell Family Institute for Breast Cancer ResearchTorontoCanada
  10. 10.Princess Margaret HospitalTorontoCanada

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