Background: Breast carcinoma is the most common malignancy among women worldwide, and skeletal metastases represent a major cause of morbidity in advanced disease. The spine is the most frequent site of bone metastasis, often resulting in pain, neurological deficits, and mechanical instability. Optimal management requires a multidisciplinary approach integrating systemic therapy, radiotherapy, and surgical intervention tailored to disease burden and patient functional status. Objectives: To evaluate the clinical profile, management strategies, and outcomes of breast carcinoma patients presenting with spinal metastases. Methods: A cross-sectional study was conducted from July 2021 to December 2021 including 450 patients with histologically confirmed breast carcinoma and radiologically proven spinal metastases. Clinical features, radiological findings, management modalities including systemic therapy, radiotherapy, and surgery and outcomes were analyzed. Results: Multimodal management was employed in the majority of patients. Combined systemic therapy and radiotherapy constituted the most common treatment approach, while surgical intervention was reserved for patients with spinal instability or neurological compromise. Significant improvement in pain and neurological function was observed in patients receiving individualized, multidisciplinary management. Conclusion: Early diagnosis and evidence-based multimodal management significantly improve functional outcomes and quality of life in breast carcinoma patients with spinal metastases.