Cancers most likely to metastasize to bone include breast , lung , prostat e, thyroid and kidney .
Carcinomas are much more likely to metastasize to bone than sarcomas.
The axial skeleton is seeded more than the appendicular skeleton, partly due to the persistence of red bone marrow in the former. The ribs, pelvis and spine are normally the first bones involved and distal bones are rarely affected. Metastases are established when a single tumor cell or a clump of cells gain access to the blood stream, reach the bone marrow through blood vessels in Haversian canals, extravasate, multiply and neovascularize. Batson's vertebral venous plexus allows cells to enter the vertebral circulation without first passing through the lungs. The sluggish blood flow in this plexus is more conducive to tumor survival, accounting for the high rate of prostate cancer metastasis to the spine.