Parkes A, et al. - Researchers investigated high-risk characteristics for patients with metastatic breast cancer with bone-only metastases (BOM). Participants were 1,445 patients with BOM followed for at least 6 months at MD Anderson Cancer Center from January 1, 1997, to December 31, 2015. At time of BOM diagnosis, 71% (n = 936) of the 1,325 patients with BOM with available pain characterization were symptomatic at time of BOM diagnosis. Patients with lytic vs blastic or sclerotic metastases and multiple vs single bone metastases experienced pain more commonly. Multiple bone metastases and both axial and appendicular skeleton involvement were among the several risk features that were found to be associated with decreased overall survival in this study.