Spinal Metastases in Breast Cancer: Single Center Experience

• Published in: World neurosurgery 2014-12, Vol.82 (6), p.1344-1350
• Main Authors: Chan-Seng, Emilie, Charissoux, Marie, Larbi, Ahmed, Tétreau, Raphäel, Gerber, Yannick Nicolas, De Verbizier-Lonjon, Delphine, Segnarbieux, François, Lonjon, Nicolas
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Breast cancer; Breast Neoplasms - pathology; Cohort Studies; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Middle Aged; Neurosurgery; Retrospective Studies; Spinal Cord Neoplasms - epidemiology; Spinal Cord Neoplasms - secondary; Spinal Cord Neoplasms - therapy; Spinal metastasis; Survival; Survival Analysis; Tomography, X-Ray Computed; Treatment; Treatment Outcome; Tumor board; Young Adult
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2014.08.010

Objective Metastases to the spine are a common manifestation of breast cancer leading to considerable reduction in the patient's quality of life. Physicians must consider the different treatments available to decrease pain, reduce tumor burden, and ensure spinal stability to prevent neurological compromises. The first objective of this study is to analyze the epidemiology and outcomes of patients with spinal metastases from breast cancer and describe changes over time in these lesions. The second objective is to establish the current treatment of spinal metastases in this type of cancer. Methods A total of 140 patients with breast cancer and spinal metastasis involvement were studied retrospectively. Demographic, clinical, and radiologic parameters were assessed, and the effects of systemic and local treatments on spinal metastasis were analyzed. Results Median patient age at diagnosis of breast cancer was 50 years (19–86 years) and average follow-up was 100 months (4–384 months). Median overall survival after diagnosis of spinal metastasis was 18.6 months. Fractures were present in 24 patients (19.3%) at diagnosis and in up to 60 cases (48.6%) by the end of the study period. Conclusions The survival rate was better in patients with spinal metastases who received specific treatment. The evolution from lytic spinal metastasis to mixed and blastic subtypes is observed with adjunctive therapy for spinal metastases (bisphosphonates, radiotherapy). Increased attention must be given for high-grade breast cancer, as spinal metastases declare faster for these stages. This study provides evidence that a multidisciplinary tumor board specifically focusing on bone metastasis is essential to effectively manage patients with breast cancer and spinal metastasis.