One of the most common sites that breast cancer metastasizes in, or spreads to, is the spinal vertebrae. This is usually because of the spread of the tumor through the body's own blood vessels to the site of metastasis. This can result in a variety of symptoms, although many victims can be asymptomatic, complicating diagnosis and treatment.
Pain
Pain is the first and main complaint in most cases, although 36 percent of spinal metastases do not cause symptoms. This pain does not abate with rest or sleep, is usually constant and gets progressively worse. The pain can be felt directly over the area of metastasis and can also be felt radiating along the distribution of a nerve in some cases. It can be attributed to the tumor pressing on the spinal cord itself, and also to the cancer destroying and replacing existing bone structure.
Pathologic Fracture
Pathologic fracture occurs because of bones weakened by disease, including metastatic cancer. Breast cancer metastases that are lytic seem to cause fractures more than blastic or mixed blastic-lytic lesions.
Vertebral Instability
Sometimes vertebral fractures brought on by metastatic breast cancers results in the spine becoming unstable. If untreated, this can cause subsequent fracturing of involved vertebrae, compression of the spinal cord and paralysis.
Spinal Cord Compression
Spinal cord comopression results from either the tumor growing into the spinal canal and impinging on the cord or a burst fracture that puts pressure on the cordl. This is an emergency that often requires prompt surgery. Symptoms can include weakness (to the point where walking is impossible), loss of limb function, problems with bowel and bladder control, sexual dysfunction and altered sensations.
References
- "Palliative Medicine, 1st Edition;" Walsh; 2008
- "Campbell's Operative Orthopaedics, 11th Edition;" Canale & Beaty; 2007
- Bonetumor.org: Pathologic Fracture by Henry DeGroot III, MD
