[Jackie07]

Has your team considered surgical relief? The data in this retrospective analysis sounds like something worth considering:

World Neurosurg. 2016 Feb 20. pii: S1878-8750(16)00310-7. doi: 10.1016/j.wneu.2016.02.065. [Epub ahead of print]
Spine surgery in patients with metastatic breast cancer. A retrospective analysis.
Telera S1, Caroli F2, Raus L2, Pompili A2, Carosi MA3, Di Santo M4, Sperduti I5, Carapella CM2, Fabi A4.
Author information
Abstract
BACKGROUND:
Pathologic or iatrogenic symptomatic spinal lesions are common in metastatic breast cancer. Given the longer duration of overall survival provided by modern oncological therapies, a prompt and effective treatment of such lesions may have a significant impact on patient's quality of life, improving pain and preventing deterioration of neurological functions.
METHODS:
A retrospective review was conducted on breast cancer patients operated to the spine between 2005 and 2013. The series include 41 patients and 57 vertebral levels treated (4 cervical, 35 dorsal, 18 lumbar). 28 patients received palliative surgery and 13 excisional surgery, according to their clinical conditions, SINS and Tokuhashi scores, RESULTS: 38 patients out of 41, presented a median survival of 50 months (CI 95% 39-61), still preserving a KPS ≥ 60 and a retained ability to ambulate independently. The median OS after the first spine surgery was also 50 months (CI 35-65), suggesting that in this cohort of patients, a reasonable quality of life was preserved almost to the end of their clinical history. In patient treated with palliative surgery, median survival was 37 months (CI 95% 26-48), in those treated with complex surgery it was 57 months (CI 95% 41-73) (p = 0.03).
CONCLUSIONS:
Major excisional surgery, albeit associated to an increased LOS, allowed in our series, a prolonged survival compared to less aggressive type of surgery. However, percutaneous or "open" BKP techniques have expanded indications for palliative surgery and even patients with lower Tokuhashi scores, may benefit from rapid and sustained pain relief, preservation of neurological function and early mobilization.