Page 645 - Read Online
P. 645
Adler et al. J Cancer Metastasis Treat 2019;5:45 I http://dx.doi.org/10.20517/2394-4722.2019.03 Page 9 of 12
A B
Figure 4. Two plane full spine radiographs of a 65 year old female patient with metastatic breast cancer(A, B). En-bloc spondylectomy in
Tomita technique at the Th9 and L1 level with a time interval of 10 years. Anterior in situ distractible cage at the Th9 level and Harms cage
at the L1 level, posterior 4-rod instrumentation Th6-L3
CONCLUSION
Evaluating prognosis by means of molecular tumor typing, previous course of disease and actual status of
metastases is mandatory prior to elective surgery of breast cancer spine metastases.
Mean survival times of 60 months in endocrine responsive (Luminal A and B) phenotypes, 50 months
in HER-2 enriched phenotypes and 15-19 months in triple negative phenotypes are described in actual
literature.
The patients’s general condition, biological age, intrinsic breast cancer subtype, comorbidities, tumor burden
(number of metastases to organs) and previous therapies influence decision making.
Regardless of molecular phenotype solitary spinal metastases may be treated with a curative therapeutic
approach.
Close cooperation of all experts participating interdisciplinary tumor boards are essential to determine
adequate therapy strategies.
