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Adler et al. J Cancer Metastasis Treat 2019;5:45 Journal of Cancer
DOI: 10.20517/2394-4722.2019.03 Metastasis and Treatment

Review Open Access

Operative treatment of metastatic breast cancer in
the spine with regard to molecular phenotypes

Daniel Adler, Wojciech Pepke, Michael Akbar

Spine Center, Department of Orthopaedic Surgery, Trauma Surgery and Division of Spinal Cord Injury, Ruprecht-Karls-University,
Heidelberg 69118, Germany.

Correspondence to: Dr. Michael Akbar, Spine Center, Department of Orthopaedic Surgery, Trauma Surgery and Division of
Spinal Cord Injury, Ruprecht-Karls-University, Schlierbacher Landstrasse 200a, Heidelberg 69118, Germany.
E-mail: Michael.Akbar@med.uni-heidelberg.de
How to cite this article: Adler D, Pepke W, Akbar M. Operative treatment of metastaticbreast cancer in the spine with regard to
molecular phenotypes. J Cancer Metastasis Treat 2019;5:45. http://dx.doi.org/10.20517/2394-4722.2019.03
Received: 2 Jan 2019 First Decision: 18 Feb 2019 Revised: 19 Mar 2019 Accepted: 10 Apr 2019 Published: 31 May 2019

Science Editor: William Schiemann Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
With more than one million new diseases per year breast cancer is the most common malignancy in women.
Metastatic breast cancer remains an incurable disease and the spinal column is most likely affected by metastases. A
significantly prolonged patient survival is the consequence of modern oncologic treatment options in the last decade.
Surgical treatment of vertebral metastases has become an increasing focus for spine surgeons. With the turn of the
millennium it was possible to classify breast cancer into four intrinsic phenotypes with various survival rates. Well
known scoring systems help surgeons to evaluate the patient´s prognosis and to choose adequate treatment options.
However, tumor entities are differentiated without regard to the molecular subtypes. In this article we describe
surgical treatment options in metastatic lesions to the spine with regard to molecular phenotypes of breast cancer
malignancy. It is crucial to correctly estimate the expected survival time to plan invasiveness of therapy regarding
metastatic spine surgery.

Keywords: Spine, metastases, breast cancer, phenotypes, subtypes, molecular level, prognosis

INTRODUCTION
Breast cancer is one of the most common cancer diseases metastasizing to the spine and the second
[1]
leading cause of deaths in woman related to cancer . Modern treatment and diagnostic concepts
including bisphosphonates go along with considerable longer survival times and a reduced rate of skeletal

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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