Advancements in Assessing Pathological Fracture Risk: News on Mirels' Score

The Mirels' score is a widely utilized tool for assessing the risk of pathological fractures in patients with metastatic bone disease. This scoring system assists clinicians in estimating fracture likelihood based on clinical, radiological, and anatomical parameters, thereby guiding treatment decisions and management strategies. This review provides a comprehensive analysis of the Mirels' score, detailing its development, clinical applications, and its role in predicting fractures across various metastatic cancers. Additionally, it discusses the score's limitations, including its potential to over- or underestimate fracture risk, and explores recent advancements in imaging and biomarker technologies that may enhance or complement its predictive accuracy. By critically examining the existing literature, this review aims to offer a thorough understanding of the Mirels' score's strengths and weaknesses, while considering its future role in personalized cancer care.