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Bonfiglio et al. J Cancer Metastasis Treat 2019;5:29                Journal of Cancer
               DOI: 10.20517/2394-4722.2018.88                           Metastasis and Treatment




               Original Article                                                              Open Access


               Can microcalcifications’ characteristics predict the
               risk of breast cancer metastasis to bone?


               Rita Bonfiglio , Manuel Scimeca , Alessandro Polidori , Clara Nazzaro , Giselda De Silva , Elena
                                                                            1
                                                              1
                                                                                           4
                           1
                                           2,3
               Bonanno 1,5
               1 Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, Rome 00133, Italy.
               2 Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Via Montpellier 1, Rome 00133, Italy.
               3 San Raffaele University, Via di Val Cannuta 247, Rome 00166, Italy.
               4 Assing S.p.a, Via Edoardo Amaldi 14, Monterotondo 00015, Italy.
               5 Diagnostica Medica’ & “Villa dei Platani”, Neuromed Group, Avellino 83100, Italy.
               Correspondence to: Prof. Elena Bonanno, Department of Experimental Medicine, University of Rome “Tor Vergata”, Via
               Montpellier 1, Rome 00133, Italy. E-mail: elena.bonanno@uniroma2.it

               How to cite this article: Bonfiglio R, Scimeca M, Polidori A, Nazzaro C, De Silva G, Bonanno E. Can microcalcifications’
               characteristics predict the risk of breast cancer metastasis to bone? J Cancer Metastasis Treat 2019;5:29.
               http://dx.doi.org/10.20517/2394-4722.2018.88
               Received: 5 Dec 2018    First Decision: 4 Jan 2019     Revised: 30 Jan 2019     Accepted: 11 Mar 2019     Published: 11 Apr 2019

               Science Editor: William Schiemann    Copy Editor: Cai-Hong Wang    Production Editor: Huan-Liang Wu



               Abstract
               Aim: To correlate the microcalcifications’ characteristics, such as morphology and elemental compositions, with the
               occurrence of bone metastatic lesions at 5 years from diagnosis.

               Methods: In this retrospective study, we enrolled 70 patients from which we collected one breast biopsy each. From
               each biopsy, paraffin serial sections were obtained to perform histological classifications, immunohistochemical
               analyses and Energy Dispersive X-ray evaluation.

               Results: Microcalcifications analysis showed a significant association between the presence of calcium crystals made
               of magnesium substituted hydroxyapatite and the development of bone metastasis from 5 years from diagnosis.
               No significant association was observed by evaluation the morphological appearance of microcalcifications.
               Immunohistochemical analysis displayed a significant association between the expression of bone morphogenetic
               proteins 2 and pentraxin-3, two osteoblast induction factors, and the formation of bone metastatic lesions.


               Conclusion: Results here reported highlighted the possible use of breast microcalcifications as a negative prognostic
               marker of bone metastatic diseases. In particular, the association between elemental composition of breast
               microcalcifications and the formation of bone lesions can lay the foundation for the development of new in vivo
               diagnostic tools based on the analysis of microcalcifications and capable to predict the formation of bone metastasis.

                           © The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
                           International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
                sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
                as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
                and indicate if changes were made.


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