Hypercalcaemia in patients with disseminated breast cancer

Ninety-three patients with breast cancer and elevated serum calcium (Ca) had a median survival of 8.5 months from the diagnosis of hypercalcaemia. The presence of symptoms, visceral disease and level of serum Ca were independent prognostic indicators for survival on multivariate analysis. Patients without symptoms, no evidence of visceral disease and Ca less than or equal to 3.0 mmol/l had the best prognosis (median survival 3.5 years) when compared to patients with one adverse prognostic feature (median survival 16 months); two or more unfavourable features identified the worst prognostic category (median survival 2.5 months). Future studies of hypercalcaemia in malignancy should assess the influence of treatment on survival as well as symptom control and should take into account disease related prognostic factors in addition to the level of serum calcium.