Abstract
Parathyroid hormone related protein (PTHrP) was first isolated from a breast cancer associated with humoral hypercalcaemia of malignancy in 1987 and is the factor responsible for the increased bone resorption and increased renal calcium reabsorption in malignancy. Recent studies suggest that around 50% of early primary breast cancers express PTHrP and tumours expressing PTHrP are more likely to subsequently develop bone metastases’. Traditionally the hypercalcaemia associated with breast cancer was believed to be caused by local release of osteolytic paracrine factors not a circulating humoral factor. The recent development of two-site immunoradiometric plasma assays for PTHrP have led to the findings that in early breast cancer less than 10% of normocalcaemic women have low levels of plasma PTHrP whilst in hypercalcaemic patients with breast cancer 90% have high levels of detectable PTHrP’.
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