Intraosseous metastatic breast cancer treatment with internal fixation and study of survival

The treatment of 31 actual or pending pathologic fractures of the long bones with open reduction and internal fixation with methylmethacrylate in 25 patients with intraosseous metastatic breast cancer is reported. Twenty hips, eight femurs, and three humeri were involved. On the basis of Wilcoxon survival curves, average life expectancy was unaltered by this treatment. However, relief of pain and overall function were significantly improved by rigid internal fixation; 74% of results were rated good (23 cases); 13% fair (four cases); and 13% poor (four cases). Three patients died within three weeks of operation; the fourth poor result was a fixation failure and was repaired with good results. Thus, the efficacy and success of open reduction and internal fixation with methylmethacrylate were confirmed, even in bones with widespread involvement. The procedure is recommended for any patient with fracture or impending fracture of the long bones secondary to metastatic breast cancer, as long as that patient's predicted survival is greater than six weeks after postoperative recovery.