Clinical & Experimental Metastasis

, Volume 32, Issue 1, pp 1–5 | Cite as

Molecular phenotype is associated with survival in breast cancer patients with spinal bone metastases

  • L. BollenEmail author
  • C. Wibmer
  • M. Wang
  • Y. M. van der Linden
  • A. Leithner
  • C. E. Bünger
  • A. B. Jensen
  • M. Fiocco
  • G. Bratschitsch
  • W. Pondaag
  • J. V. M. G. Bovée
  • P. D. S. Dijkstra
Research Paper


To aid in therapy selection for patients with spinal bone metastases (SBM), predictive models have been developed. These models consider SBM from breast cancer a positive predictive factor, but do not take phenotypes based on estrogen (ER), progesterone (PR) and human epidermal growth factor 2 (HER2) receptors into account. The aim of this study was to ascertain whether receptors are associated with survival, when the disease has progressed up to SBM. All patients who were treated for SBM from breast cancer between 2005 and 2012 were included in this international multi-center retrospective study (n = 111). Reports were reviewed for ER, PR and HER2 status and subsequently subdivided into one of four categories; luminal A, luminal B, HER2 and triple negative. Survival time was calculated as the difference between start of treatment for SBM and date of death. Analysis was performed using the Kaplan–Meier method and log-rank tests. Median follow-up was 3.7 years. Survival times in the luminal B and HER2 categories were not significantly different to the luminal A category and were joined into a single receptor positive category. Eighty-five patients (77 %) had a receptor positive phenotype and 25 (23 %) had a triple negative phenotype. Median survival time was 22.5 months (95 %CI 18.0–26.9) for the receptor positive category and 6.7 months (95 %CI 2.4–10.9) for the triple negative category (p < 0.001). Patients with SBM from breast cancer with a triple negative phenotype have a shorter survival time than patients with a receptor positive phenotype. Models estimating survival should be adjusted accordingly.


Spinal bone metastases Survival Breast cancer Molecular phenotype Receptor status 



The authors would like to thank V.T.H.B.M. Smit for his advice on pathology, breast cancer and molecular phenotypes.

Conflict of interest

The authors report no conflicts of interest and have no funding sources to disclose.


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • L. Bollen
    • 1
    Email author
  • C. Wibmer
    • 2
  • M. Wang
    • 3
  • Y. M. van der Linden
    • 4
  • A. Leithner
    • 2
  • C. E. Bünger
    • 3
  • A. B. Jensen
    • 5
  • M. Fiocco
    • 6
  • G. Bratschitsch
    • 2
  • W. Pondaag
    • 7
  • J. V. M. G. Bovée
    • 8
  • P. D. S. Dijkstra
    • 1
  1. 1.Department of Orthopedic SurgeryLeiden University Medical CenterLeidenThe Netherlands
  2. 2.Department of Orthopedic SurgeryMedical University of GrazGrazAustria
  3. 3.Department of Orthopedic EAarhus University Hospital NBGAarhusDenmark
  4. 4.Department of Clinical OncologyLeiden University Medical CenterLeidenThe Netherlands
  5. 5.Department of OncologyAarhus University Hospital NBGAarhusDenmark
  6. 6.Department of Medical Statistics and BioinformaticsLeiden University Medical CenterLeidenThe Netherlands
  7. 7.Department of NeurosurgeryLeiden University Medical CenterLeidenThe Netherlands
  8. 8.Department of PathologyLeiden University Medical CenterLeidenThe Netherlands

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