title: Failure and success in the treatment of breast carcinoma in men: a case report.
abstract: BACKGROUND
  Male breast cancer (MBC) represents a rare cause of vertebral body compression fractures along with severe pain restricting the patient's daily functioning. Limited number of cases, lack of awareness among patients and physicians leading to delayed management, further increase the average age and disease progression at presentation, resulting in a poor prognosis. Additionally, studies on MBC treatment protocols and the use of female algorithms are unavailable. The implementation of vertebroplasty or kyphoplasty often results in unsatisfactory outcome due to recurrent pain and loss of vertebral height. Stentoplasty could become an alternative procedure, as described in the following case study.
  
  
  METHODS
  54-yr-old male patient with history of breast carcinoma presented with pain in the vertebral column. Baseline X-ray and CT scan revealed multiple osteosclerotic and osteolytic metastatic lesions in the thoracic vertebrae along with a compression fracture at T9. Stentoplasty was performed to limit fracture progression. Intraoperative scan revealed restoration of the vertebral body shape. Following surgery, direct reduction in pain was obtained. Postoperative 1-year follow-up did not show any loss in height of the operated vertebra. Results of adjuvant chemotherapy administration and a new method of treatment of compression fractures caused by metastatic lesions were compared with previously published studies.
  
  
  CONCLUSIONS
  Stentoplasty with Vertebral Body Stenting-System is an innovative method that can be applied in kyphoplasty for compression fractures caused by metastatic lesions. Nevertheless, further research on the systemic treatment of MBC is needed.
authors.affiliation: Department of General, Oncologic and Endocrine Surgery, Voivodeship Hospital in Kielce, Kielce, Poland.
authors.forename: Krystian
authors.initials: K
authors.lastname: Kaczmarek
authors.affiliation: Department of General, Oncologic and Endocrine Surgery, Voivodeship Hospital in Kielce, Kielce, Poland.
authors.forename: Marta P
authors.initials: MP
authors.lastname: Wiącek
authors.affiliation: Department of Spinal Surgery, Orthopedic Oncology and Traumatology, W. Dega University Hospital Poznań, Poznań, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Sulewski
authors.affiliation: Department of Orthopedics and Traumatology, W. Dega University Hospital Poznań, Poznań, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Kubaszewski
authors.affiliation: Department of Orthopedics and Traumatology, W. Dega University Hospital Poznań, Poznań, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kaczmarczyk
authors.affiliation: Department of Spinal Surgery, Orthopedic Oncology and Traumatology, , W. Dega University Hospital Poznań, Poznań, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Nowakowski
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D018567:Breast Neoplasms, Male / Q000150:complications* / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000556:secondary* / Q000628:therapy*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005472:Fluorouracil / Q000627:therapeutic use; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D058498:Kyphoplasty; D008207:Lymphatic Metastasis; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D015607:Stents; D013629:Tamoxifen / Q000008:administration & dosage; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054854:Vertebroplasty
chemical_list: D013629:Tamoxifen; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate