This retrospective study was carried out at Radiation Therapy Department, National Cancer Institute, Cairo University during the period from January 1991 to December 1998. It included 702 breast cancer patients with bone metastases only as the first sign of distant relapse. Both the incidence and development of visceral metastases, disease progression and 5-year visceral metastases free survival were affected by the following factors age of the patient at time of first presentation of breast cancer; tumor grade; axillary lymph node infection; disease free interval (time interval before development of bone metastases); adjuvant hormonal therapy as well as hormonal therapy after bone metastases.