American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which cancer type is most commonly associated with bone metastases?

1. Colon cancer

2. Breast cancer

3. Lung cancer

4. Melanoma

The correct answer is: Breast cancer

Breast cancer is the cancer type most commonly associated with bone metastases due to its propensity to spread to the skeletal system. When breast cancer cells metastasize, they often travel through the bloodstream or lymphatic system and preferentially invade the bones, particularly the spine, pelvis, ribs, and long bones. This tendency results from specific biological factors that make bone an attractive site for metastatic growth. The bidirectional interaction between the breast tumor cells and the bone microenvironment can further enhance this process. Osteoclast activation and bone remodeling are frequently stimulated by the presence of breast cancer, which creates an environment conducive to tumor colonization. This phenomenon is a critical factor in the management of advanced breast cancer, as the presence of bone metastases can significantly influence treatment decisions and patient prognosis. While other cancers, such as colon cancer, lung cancer, and melanoma, can also lead to bone metastases, their overall frequency is lower compared to breast cancer. Understanding the specific tendencies of different cancer types for metastasis can aid in clinical diagnosis and treatment planning.