Skeletally Related Events (SRE) In Breast Cancer

Dr. Mishil S. Parikh

MBBS, MS (Ortho), Mch (OrthoOnco)

Consultant Orthopaedic Oncosurgeon at Sir HN

Reliance Foundation Hospital

Experience is coupled with genuine concern for patients, says Dr. Mishil Parikh.

After completing his Graduation and Post-graduation from D.Y. Patil Medical College, Navi Mumbai, he trained in musculoskeletal oncology at the Prestigious Tata Memorial Hospital. Dr. Parikh is one of the youngest trained and certified OrthoOnco Surgeons in India. He is one of the very few surgeons practicing exclusive Musculoskeletal Oncology.

He specializes in pain-free and accurate needle biopsies, limb salvage techniques, and treatment of pathological fractures and spinal cord compression due to metastasis and has an extensive experience and skill in the management of Bone and Soft Tissue Tumors.

Over the past 6 years, he has done around 1500 procedures and treated around 2000 patients suffering from bone and soft tissue-related tumors.

Dr. Parikh currently is the Chairperson for the under-40 sarcoma surgeons in the International Society of Limb Salvage. He has over 25 publications and is on the editorial board for many journals. He is also a Founder and Member of the Sarcoma Education Foundation, a Non-Profit organization that helps young Orthopaedic Oncosurgeons to get trained in this specialized field. He also actively participates in the Bombay Orthopaedic Society and has the additional role of being their Webmaster.

Breast Cancer is the Second most common cancer in females. In this modern era, with the advent of newer drugs for chemotherapy and targeted therapy, the overall survival of patients with Breast Cancer has improved significantly. Since this is a cancer which has good outcomes, the longevity of the patients is also good.

When the cancerous cells spread from its primary site to any other organ it is called Metastasis. In Breast Cancer, Bone is the commonest site for metastasis. This spread isn’t life threatening but it causes pain, difficulty in movements and even fractures. Hence leading to a poor quality of life.

The aim of managing Skeletally Related Events (SREs) is to maintain a good quality of life.

The symptoms of bone metastasis are:

Bone pain

Fracture from bone weakness

Nerve compression

If a person is experiencing symptoms and thinks they might have bone metastasis, they should contact a doctor for a diagnosis.

Doctors typically use at least one imaging scan when assessing for bone metastasis. Possible imaging tests include:

X-ray

MRI scan

Bone scan

Additionally, a biopsy may help determine bone metastasis. To take a biopsy, an Orthopaedic Oncosurgeon uses a needle to collect a tissue sample from the potentially cancerous area of the bone. Trained pathologists analyze the sample for signs of cancer.

Treatment Options:

The Focus is on controlling the cancer by reducing or stopping its growth and minimizing symptoms of pain The goal of the treatment plan determines a person’s treatment options.

Some may use bone-strengthening drugs, which include Zoledronic acid

Denosumab

These drugs can help by:

Reducing the likelihood of skeletal-related events, such as fractures

Relieving pain

Reducing the need for other treatment options, such as chemotherapy

Other treatment options include:

Surgery

Prophylactic Surgery In Weak Bone Before Fracture Fixation Surgery after Fracture

Message: Don’t ignore Bone Pain, get evaluated and treated in time to maintain a Good Quality of Life.