Wednesday, 20 April 2022

 

The role of percutaneous vertebral augmentation in patients with metastatic breast cancer: Literature review including report of two cases

by Ozge Gumusay, Laura A. Huppert, Spencer C. Behr, Hope S. Rugo 

The Breast: Published: April 01, 2022

Abstract

Patients with metastatic breast cancer are at high risk for developing vertebral compression fractures due to underlying bone metastases and bone density loss. Vertebral augmentation techniques including percutaneous vertebroplasty and percutaneous balloon kyphoplasty are techniques used to stabilize compression fractures and improve pain. However, rare complications from these interventions have been observed, including spinal cord compression, nerve root compression, venous cement embolism, and pulmonary cement embolism. These complications pose unique potential challenges for patients with cancer who may already have decreased lung function and potential for venous thromboembolism. In this review, we first describe the role of percutaneous vertebral augmentations in patients with metastatic cancer, with a particular focus on patients with breast cancer. Then, we describe complications of vertebral augmentation in two patients with metastatic breast cancer including long-term symptomatic and radiographic follow-up.

Highlights

•Balloon kyphoplasty and percutaneous vertebroplasty are used to stabilize compression fractures and improve pain.

•Leakage of bone cement can cause cement emboli which can depsit in locations such as the pulmonary and renal vasculature.

•Management of cement emboli depends on the amount of cement embolized and the severity of symptoms.

•Future studies are needed to better understand the long-term radiographic and clinical consequences of cement emboli.