Medical Student Baylor College of Medicine Baylor College of Medicine
Disclosure(s):
Caleb C. Witsken, BS: No financial relationships to disclose
Introduction: Breast cancer is one of the most prevalent cancers, affecting approximately 13% of women in the US during their lifetimes. Over half of the patients with stage IV breast cancer develop bone metastases, with the spine being the most frequent site. Despite the high incidence and impact of spinal metastases from breast cancer, limited research exists on their specific outcomes. This study aims to compare the outcomes of spinal metastases in breast cancer patients with those in patients with other cancers.
Methods: Using the TriNetX research network, which includes data from 92 large healthcare organizations, we identified patients who underwent surgery for spinal metastases between July 29, 2004, and July 29, 2024. Patients were categorized into two cohorts: those with breast cancer and those with other cancers. A 1:1 propensity score matching was performed to control for demographic and comorbidity differences. Outcomes analyzed included 5-year survival, disease progression, 2-year mechanical complications, and 90-day postoperative complications.
Results: The study included 1,956 breast cancer patients and 9,986 patients with other cancers, with matched cohorts of 1,523 patients each. Median survival was 1,326 days for the breast cancer cohort versus 648 days for the other cancer cohort. The 5-year survival probability was 40.33% for breast cancer patients and 29.42% for other cancer patients, with a hazard ratio of 0.66 (CI 0.60, 0.73; p=0.001). The 90-day risk of medical complications was lower in the breast cancer group (15.13%) compared to the other cancers group (22.08%), with a risk ratio of 0.69 (CI 0.53, 0.90; p=0.005). Risks of pulmonary embolism, deep vein thrombosis, stroke, and blood transfusion were also significantly lower in the breast cancer cohort (all p< 0.01). There was no significant difference in 5-year disease progression or 2-year mechanical complication risk between the cohorts.
Conclusion : Breast cancer patients with spinal metastases exhibit significantly higher survival rates and lower risks of postoperative complications compared to those with spinal metastases from other cancers. These findings underscore the importance of nuanced decision-making and specialized care plans in treating these different patient populations. Further research is warranted to determine the factors contributing to this variability in outcomes.