Brain Metastases in Breast Cancer

Niikura, Naoki; Tokuda, Yutaka; Iwata, Hiroji

doi:10.1093/jjco/hyu156

Cited by 28 publications

(29 citation statements)

References 95 publications

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“…In most cases, vision preservation was achieved. In comparison, the median survival for BC with brain metastases is 7–10 months . Thus, OM appear to portend a longer survival time than brain metastases.…”

Section: Discussionmentioning

confidence: 94%

Orbital Metastases from Breast Cancer: Retrospective Analysis at an Academic Cancer Center

et al. 2016

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Orbital metastases from breast cancer (BC) are rare, but often debilitating. BC accounts for nearly half of metastases to the orbit. Orbital metastases may be discovered years after the initial diagnosis of BC, and are rare at initial presentation. A search of the institutional data base at an academic cancer center identified BC patients who developed or presented with orbital metastases from 2000 to 2013. Baseline characteristics, treatment modalities, survival and treatment responses were collected from the electronic medical record. There were 20 patients identified with orbital metastases (0.7% of all BC cases). The median age at diagnosis of BC was 49 years; 80% had estrogen positive disease. The interval between the initial diagnosis of BC and the presentation of orbital metastases was 8.5 years (0-19 years). Orbital disease was the initial presentation of BC in two cases. Three patients developed bilateral orbital metastases and seven had accompanying brain metastases. The most common presentation was decreased vision (55%), followed by diplopia (25%). The median survival after orbital metastases was 24 months. Thirteen patients (65%) received local radiation therapy. Of those radiated, 90% reported improvement of orbital symptoms. Other treatments included intraocular bevacizumab, surgery, and systemic therapy. Orbital metastases tend to occur in estrogen receptor positive disease and are often found years after BC onset. Orbital metastases may be associated with the development of brain metastases. Radiotherapy is the preferred local therapy and had high symptom control in this cohort. Oncologists should be aware of the signs of orbital metastases and the treatment options.

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Section: Discussionmentioning

confidence: 94%

Orbital Metastases from Breast Cancer: Retrospective Analysis at an Academic Cancer Center

et al. 2016

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“…The incidence of brain metastasis detection in breast cancer is increasing due to advances in imaging technologies and the introduction of novel therapies resulting in longer survival times (9,19). In-depth understanding of the natural history of brain metastases can aid in the optimization of treatment and follow-up strategies.…”

Section: Discussionmentioning

confidence: 99%

“…Brain metastases usually occur late in the disease course of breast cancer, and are uncommon at the time of initial diagnosis of breast cancer (2,3). The risk factors for brain metastases include young age, tumor stage, human epidermal growth factor receptor (HER2)-positivity, triple-negativity, number of metastatic sites (n>2) and large tumor size (4–9). It has been estimated that 10–15% of patients with breast cancer will develop brain metastases (10), while postmortem studies have detected brain metastases in up to 30% of patients (11).…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome of brain metastases differs significantly among breast cancer subtypes

et al. 2017

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Brain metastases in patients with breast cancer are associated with a poor survival rate. A small number of studies have challenged this premise, suggesting that survival times following brain metastasis differ significantly between breast cancer subtypes. In the current study, overall survival (OS), brain metastases-free survival (BMFS) and survival following brain metastases (SFBM) were found to be associated with the intrinsic breast cancer subtype. A total of 1,147 patients with invasive breast cancer who were treated at the Hannover Medical School between January 2004 and December 2010 were included, from which 54 patients with brain metastases were identified. The Kaplan-Meier method or Cox regression analyses were performed for analysis of survival. OS was found to differ significantly between breast cancer subtypes: OS was significantly shorter in patients with triple-negative (TN) cancer compared with patients with human epidermal growth factor receptor (HER2)-enriched tumors (P<0.001). In addition, median BMFS times differed significantly between luminal (1,003 days), HER2-enriched (514 days) and TN breast cancer patients (460 days) (P=0.045). The median durations of SFBM were 386 days in luminal, 310 days in HER2-enriched and 147 days in TN breast cancer patients (P=0.029). The results suggested that patients with luminal breast cancer have a lower risk of brain metastases and the most favorable outcome with regard to BMFS, whereas patients with HER2-positive or TN breast cancer have a significantly higher risk of developing brain metastases. Compared with TN breast cancer, the duration of SFBM was doubled in HER2-enriched cancers. These findings may have important implications for treatment and follow-up strategies in patients with breast cancer.

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“…[81] In patients with breast cancer BM are less common than bone or visceral metastases and frequently represent a late event; nevertheless, up to 16% of metastatic breast cancer patients develop clinically significant BM while autopsy studies showed that up to 30% of patients actually develop brain disease. [3,82] Several risk factors have been associated with the development of BM in patients with metastatic breast cancer, particularly the young age (35 . [83] Patients with HER2-positive metastatic breast tumors are 2-4 times more likely to develop CNS tumors than patients with HER2-negative disease [82] and patients with triple negative breast cancer and basal like breast cancer (BLBC) also appear to be at a high risk for developing BM.…”

Section: Breast Cancermentioning

confidence: 99%

“…[3,82] Several risk factors have been associated with the development of BM in patients with metastatic breast cancer, particularly the young age (35 . [83] Patients with HER2-positive metastatic breast tumors are 2-4 times more likely to develop CNS tumors than patients with HER2-negative disease [82] and patients with triple negative breast cancer and basal like breast cancer (BLBC) also appear to be at a high risk for developing BM. [84] The HER2/neu gene is amplified in 20-25% of primary breast cancer cases; however, gene expression profiles can vary between the primary tumor and metastatic formations and therefore it could not be correct to assume that the HER2 status of the metastatic tumor reflects that of the primary tumor.…”

Section: Breast Cancermentioning

confidence: 99%

Brain infiltration by cancer cells: different roads to the same target?

Paolillo¹,

Schinelli²

2015

J Cancer Metastasis Treat

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Brain infiltration by cancer cells is a complex process in which metastatic cells detached from the primary tumor must firstly survive in the blood flow, cross the blood brain barrier (BBB) and finally colonize a foreign microenvironment. The cells that successfully bypass the cellular barriers surrounding capillaries, proliferate to form micrometastasis and trigger the angiogenetic process. Different molecular mechanisms have been proposed to explain the metastatic behaviour of solid tumors that infiltrate brain tissue; in this review the most recent findings concerning mechanisms and genes potentially involved in brain metastasis, that differ according to primary tumor types, will be discussed. The three tumors that more frequently develop brain metastasis, lung cancer, breast cancer and melanoma, will be considered and, in addition, the role of BBB and the process of endothelial to mesenchymal transition in cancer metastasis will be briefly described.

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Brain Metastases in Breast Cancer

Cited by 28 publications

References 95 publications

Orbital Metastases from Breast Cancer: Retrospective Analysis at an Academic Cancer Center

Orbital Metastases from Breast Cancer: Retrospective Analysis at an Academic Cancer Center

Clinical outcome of brain metastases differs significantly among breast cancer subtypes

Brain infiltration by cancer cells: different roads to the same target?

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