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. 2019 Nov 11;17(6):538–547. doi: 10.1007/s11914-019-00545-7

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© The Author(s) 2019

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided 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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Fig. 2 — Potential role of osteoporosis and MCP-1 in breast cancer bone metastasis. PTHrP plays a pivotal role in breast cancer progression and osteoblastic expression of MCP-1. This relationship between PTHrP and osteoblastic expression of MCP-1 related to cancer progression may drive the colonisation of disseminated breast cancer cells in the bone. The increased osteoclast activity associated with osteoporosis results in an increase in MCP-1 expression. This further increase in MCP-1 expression in osteoporotic bone may increase the rate and likelihood of bone metastasis following breast cancer. MCP-1 is also involved in breast cancer progression, and so forms a vicious cycle of MCP-1 and PTHrP expression in progressing breast cancer, and MCP-1 expression in bone that encourages bone metastasis