Breast cancer brain metastases – A 12 year review of treatment outcomes

Ieso, P.B. De; Schick, Ulrike; Rosenfelder, N.; Mohammed, Kabir; Ross, Gill

doi:10.1016/j.breast.2015.03.007

Cited by 28 publications

(23 citation statements)

References 40 publications

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“…Similar to previous studies (12–19,21,23), our FDG uptake times were longer for PET/MR imaging than for PET/CT, which could allow for greater lesion conspicuity at the delayed examination. However, we found the diffusion-weighted sequence accounted for the detection of additional liver metastases and the contrast-enhanced T1-weighted sequence accounted for the detection of brain metastases.…”

Section: Discussionsupporting

confidence: 86%

“…Brain metastases are common among patients with breast cancer, they are treatable (12), and they were seen on PET/MR images in 10% of these patients. Although PET/CT did not include the brain in over half of these patients, available data suggest PET/CT depicts only 50%–70% of known presumably symptomatic brain metastases (6,7).…”

Section: Discussionmentioning

confidence: 99%

“…These sites are particularly important in the early detection of metastases, as local treatment of liver (9,10) and brain (11,12) lesions has been shown to improve survival, local control, and quality of life.…”

mentioning

confidence: 99%

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Comparison of Whole-Body¹⁸F FDG PET/MR Imaging and Whole-Body¹⁸F FDG PET/CT in Terms of Lesion Detection and Radiation Dose in Patients with Breast Cancer

Melsaether¹,

Raad²,

Pujara³

et al. 2016

Radiology

104

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Purpose To compare fluorine 18 (18F) fluorodeoxyglucose (FDG) combined positron emission tomography (PET) and magnetic resonance (MR) imaging with 18F FDG combined PET and computed tomography (CT) in terms of organ-specific metastatic lesion detection and radiation dose in patients with breast cancer. Materials and Methods From July 2012 to October 2013, this institutional review board–approved HIPAA-compliant prospective study included 51 patients with breast cancer (50 women; mean age, 56 years; range, 32–76 years; one man; aged 70 years) who completed PET/MR imaging with diffusion-weighted and contrast material–enhanced sequences after unenhanced PET/CT. Written informed consent for study participation was obtained. Two independent readers for each modality recorded site and number of lesions. Imaging and clinical follow-up, with consensus in two cases, served as the reference standard. Results There were 242 distant metastatic lesions in 30 patients, 18 breast cancers in 17 patients, and 19 positive axillary nodes in eight patients. On a per-patient basis, PET/MR imaging with diffusion-weighted and contrast-enhanced sequences depicted distant (30 of 30 [100%] for readers 1 and 2) and axillary (eight of eight [100%] for reader 1, seven of eight [88%] for reader 2) metastatic disease at rates similar to those of unenhanced PET/CT (distant metastatic disease: 28 of 29 [96%] for readers 3 and 4, P = .50; axillary metastatic disease: seven of eight [88%] for readers 3 and 4, P > .99) and outperformed PET/CT in the detection of breast cancer (17 of 17 [100%] for readers 1 and 2 vs 11 of 17 [65%] for reader 3 and 10 of 17 [59%] for reader 4; P < .001). PET/MR imaging showed increased sensitivity for liver (40 of 40 [100%] for reader 1 and 32 of 40 [80%] for reader 2 vs 30 of 40 [75%] for reader 3 and 28 of 40 [70%] for reader 4; P < .001) and bone (105 of 107 [98%] for reader 1 and 102 of 107 [95%] for reader 2 vs 106 of 107 [99%] for reader 3 and 93 of 107 [87%] for reader 4; P = .012) metastases and revealed brain metastases in five of 51 (10%) patients. PET/CT trended toward increased sensitivity for lung metastases (20 of 23 [87%] for reader 1 and 17 of 23 [74%] for reader 2 vs 23 of 23 [100%] for reader 3 and 22 of 23 [96%] for reader 4; P = .065). Dose reduction averaged 50% (P < .001). Conclusion In patients with breast cancer, PET/MR imaging may yield better sensitivity for liver and possibly bone metastases but not for pulmonary metastases, as compared with that attained with PET/CT, at about half the radiation dose.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Comparison of Whole-Body¹⁸F FDG PET/MR Imaging and Whole-Body¹⁸F FDG PET/CT in Terms of Lesion Detection and Radiation Dose in Patients with Breast Cancer

Melsaether¹,

Raad²,

Pujara³

et al. 2016

Radiology

104

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“…De Ieso ve ark., HER-2 pozitif olan olgularda, HER-2 negatif olan olgulara göre ortanca sağkalım daha yüksek olup, daha agresif lokal tedavi uygulanması gerektiğini vurgulamışlardır (9). Leone ve ark., meme kanserinin teşhis anındaki evresi yüksek oldukça, teşhis ile beyin metastazı gelişmesi arasındaki sürenin o kadar kısa olduğunu göstermişlerdir (10).…”

Section: Discussionunclassified

Supra- and Infratentorial Cystic Metastases of Breast Cancer: Case Report

Tatarlı¹,

Gergin²,

Özdoğan³

et al. 2016

Acta Oncol Tur.

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ÖZETMeme kanserinin kranial metastazları; kemik, dura veya beyin parankimine olmaktadır. Semptomlar metastazın lokalizasyonuna göre değişir. Kitleler; solid, kistik veya parsiyel kistik şekilde olabilirler. Meme kanserinin kistik intrakranial metastazları oldukça nadirdir. Cerrahi sonrası radyoterapi ve/veya kemoterapi uygulanır. Kırksekiz yaşında bayan olgu, baş ağrısı ve generalize tonik-klonik nöbet şikayetleri ile başvurdu. Sekiz yıl önce sol meme kanseri nedeniyle sol total mastektomi ve sol koltukaltı lenfadenektomi ameliyatı yapılmış. Patolojisi adenoid kistik karsinom olarak gelmiş. Lenf nodlarında metastaz tespit edilen olguya adjuvan kemoterapi uygulanmış. Meme ameliyatından sekiz yıl sonra yapılan kranial MRG'sinde (Manyetik Rezonans Görüntüleme) sol frontalde ve serebellar orta hatta büyük kistik kitle lezyonları tespit edildi. Yapılan PET-CT (Pozitron Emisyon Tomografi) incelemesinde, başka herhangi bir organında metastaz tespit edilmedi. Meme açısından yapılan genel cerrahi konsültasyonunda herhangi bir patoloji bulunmadı. Her iki kranial lezyon nedeniyle bir hafta arayla iki kez ameliyat edilen olgunun yapılan patolojik incelemesinde, kistik meme kanseri metastazı tespit edildi. Ameliyat sonrasında olguya tüm beyin radyoterapi uygulandı. Kemoterapi uygulanmadı. Bu olgu dolayısıyla kranial kistik metastazlarda, ender de rastlansa meme kanseri metastazlarını ayırıcı tanıda düşünmemiz gerektiğini vurgulamak istedik. Anahtar Kelimeler: Kistik intrakranial metastaz, meme kanseri, kistik metastaz, beyin metastazı ABSTRACT Breast cancer is most frequently metastasize dura, bone and parenchyma in cranial tissue. Symptoms vary according to the location of the metastasis. Masses may be solid, cystic and partial cystic form. Cystic intracranial metastases of breast cancer is very rare. Radiotherapy and/or chemotherapy could be performed after surgery. Forty-eight-year-old female patient was admitted with complaints of headache and generalized tonicclonic seizure. Patient underwent surgery for cancer of the left breast for eight years ago. Left total mastectomy and left axillary lymphadenectomy was performed. Pathology was determined as adenoid cystic carcinoma. Adjuvant chemotherapy was applied to patients with lymph nodes metastasis detected. Cranial MRI (Magnetic Resonance Imagination) was performed after eight years after breast surgery. In the left frontal and cerebellar midline, large cystic mass lesions were detected in cranial MRI. PET-CT (Positron Emission Tomography) examination was not detected in any other organ metastases. There was no pathology in terms of breast surgery consultation. Both cranial lesions were underwent surgery twice in one week. In the pathological examination of the patient, cystic breast cancer metastasis was detected. Whole brain radiotherapy was performed to the patient after surgery. We want to emphasize that in cranial cystic metastasis, rarely come across if breast cancer metastasis should be considered in differential diagnosis.

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“…Outcome of these tumor types with BM may differ. Secondly, though breast cancer BM are distributed equally in both arms, breast cancer HER-2 positive tumor subtype may show better outcome compared to triple negative breast cancer [2]. Therefore, description of breast tumor subtypes may better define the outcome in both arms.…”

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confidence: 99%

Tumor types, breast tumor subtypes and extension of systemic disease may influence outcome in cancer patients with brain metastases

Altundağ

2017

J Neurooncol

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Breast cancer brain metastases – A 12 year review of treatment outcomes

Cited by 28 publications

References 40 publications

Comparison of Whole-Body¹⁸F FDG PET/MR Imaging and Whole-Body¹⁸F FDG PET/CT in Terms of Lesion Detection and Radiation Dose in Patients with Breast Cancer

Comparison of Whole-Body¹⁸F FDG PET/MR Imaging and Whole-Body¹⁸F FDG PET/CT in Terms of Lesion Detection and Radiation Dose in Patients with Breast Cancer

Supra- and Infratentorial Cystic Metastases of Breast Cancer: Case Report

Tumor types, breast tumor subtypes and extension of systemic disease may influence outcome in cancer patients with brain metastases

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Breast cancer brain metastases – A 12 year review of treatment outcomes

Cited by 28 publications

References 40 publications

Comparison of Whole-Body18F FDG PET/MR Imaging and Whole-Body18F FDG PET/CT in Terms of Lesion Detection and Radiation Dose in Patients with Breast Cancer

Comparison of Whole-Body18F FDG PET/MR Imaging and Whole-Body18F FDG PET/CT in Terms of Lesion Detection and Radiation Dose in Patients with Breast Cancer

Supra- and Infratentorial Cystic Metastases of Breast Cancer: Case Report

Tumor types, breast tumor subtypes and extension of systemic disease may influence outcome in cancer patients with brain metastases

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Product

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Comparison of Whole-Body¹⁸F FDG PET/MR Imaging and Whole-Body¹⁸F FDG PET/CT in Terms of Lesion Detection and Radiation Dose in Patients with Breast Cancer

Comparison of Whole-Body¹⁸F FDG PET/MR Imaging and Whole-Body¹⁸F FDG PET/CT in Terms of Lesion Detection and Radiation Dose in Patients with Breast Cancer