Introduction: Due to an increase in survival skeletal metastasis becomes a significant factor on life quality in carcinoma patients. Also shown in publications of the last years the surgical approach and the expected prognosis are very much based on the primary. Especially patients with breast carcinoma show very long survival times, which must be considered in choosing the adequate surgical approach. Aim of this study was to proof that on a large collective of consecutively treated patients.

Methods: Between 1980 and 2005 115 patients with metastatic disease to the bone due to breast carcinoma had been surgically treated. In 112 female and 3 male the mean age at surgery was 58 years (17–84 years). Retrospectively location and extension of the disease, symptoms, surgical approaches, complications, recurrencies and survival time had been evaluated.

Results: The most often peformed procedure was a decompression with or without stabilisation of the spine in 42 cases. Four vertebroplasties had been additionally performed. The proximal femur had to be reconstructed with an endoprotsthetic device in 24 cases, an endoprostehtic reconstruction of the humerus was necessary in 2 patients, of the pelvis in one case. One diaphyseal prothesis was implanted. Two resctions/amputation without any reconstruction had to be performed. In 20 cases a compound osteosynthesis, in 19 cases a biopsy only was done. In most of the cases postsurgical radiation was administered in some cases preoperative radiation had been applied. Follow-up was done 1 to 26 years after surgery (average 11.7 years).

Many pateints showed an extented survival despite disseminated disease with a high and quality of life. Radical resection as tried in a few patients did not proof to be beneficial regarding the prognsotic effect.

Conclusions: Patients with skeletal manifestations of breast carcinoma showed long survival times despite extented disease. The intralesional surgical approach including radiation therapy showed a better functional outcome in comparison to radical procedures with no disadvantage in survival time or local recurrencies.

In tissue engineering, scaffolds are vitalized by cells in vitro. Human mesenchymal stem cells (hMSC) are very interesting because of their ability to differentiate towards the osteogenic lineage and their self renewing capacity. Yet, it is important that implanted cells do not disseminate and exhibit unwanted cell growth outside the implantation site. Therefore the aim of this study was to detect migrated cells in organs of mice after implantation of a composite (cell-scaffold) substitute.

HMSC (Cambrex, USA) were inoculated on a clinically approved 3D scaffold (Tutobone(TM), Tutogen, Germany). One composite and one scaffold without cells were implanted subcutanously, left and right paravertebrally in athymic nude mice (nu/nu). After 2, 4, 8 and 12 weeks constructs were explanted and organs (liver, spleen, lungs, kidney, heart, testicles, brain and blood) were harvested. The entire organs were homogenized and genomic DNA was isolated for qualitative and quantitative PCR.

Human DNA was found in all explanted composites at all examined time points. No human DNA could be detected in control scaffolds. Moreover we did not detect human DNA in all explanted organs at any time point. As internal controls we could detect 1 single hMSC in a pool of 106 mouse cells.

In conclusion, we could proof that cells of implanted composite substitutes do not migrate to other organs. Furthermore, this study showed that implanted hMSC seeded on 3D scaffolds survive over time frames up to 12 weeks.