Central nervous system metastasis from breast carcinoma autopsy study

Abstract

Central nervous system (CNS) metastasis was noted in 309 patients of 1044 autopsy cases of breast carcinoma. The brain was involved in 193 cases, and cranial dura in 167 cases. In 82 cases, the cranial dura was the sole site of CNS involvement. Metastasis to the leptomeninges was found in 59 cases, and to the spinal cord and dura in 32 cases. Metastases to the infratentorial portion of the brain was almost as frequent as to the cerebrum. Forty‐two percent of the brain metastasis were single lesions, which is similar to the frequency of solitary metastasis to the brain from malignant tumors as a whole. CNS metastasis occurred more frequently in younger patients than older patients, and the clinical course of these patients was shorter than for those patients without CNS metastasis. CNS metastasis developed in the late stage of the disease, and often was not recognized clinically. Only 31% of the cases were clinically diagnosed or suspected before death. A median survival of these patients after clinical diagnosis of CNS metastasis was 33 days. However, a significant improvement was noted in the clinical diagnosis and median survival in the latter half of the study period. Eleven patients lived for more than 1 year after diagnosis of CNS metastasis. Only 14% of the 309 patients died from CNS failure. Cancer 52:2349‐2354, 1983.

Antidepressant use and risk of central nervous system metastasis

“…These percents are supported by other autopsy studies, which found 42% of brain metastases of breast cancer patients were single lesions [145,147]. One retrospective study found only 15.3% of patients had single lesions [155].…”

“…Within the parenchyma, the brain tissue, brain metastasis is most common in the cerebral hemispheres [4,145]. Up to 85% of brain metastases occur in these hemispheres, whereas only 10% to 25% occurs in the cerebellum and 1% to 3% in the brain stem [146,147].…”

“…Metastatic CNS tumors should be in the differential diagnosis if a cancer patient reports neurological symptoms such as headaches, nausea, cognitive problems, seizures, dysphasia, motor weakness, or sensory disturbances, since these metastases are usually symptomatic [139,145,153,[156][157][158]. CNS metastasis symptoms can either be generalized or focal.…”

Risk factors for brain relapse in HER2-positive metastatic breast cancer patients

“…Brain is among the most common sites of relapse in breast cancer, with the clinical and autopsy occurrence of 14-20% and 18-30%, respectively [1,2]. Relapse in the brain is related to high morbidity and mortality, with relatively few effective therapeutic options.…”

Intracarotid delivery of oncolytic HSV vector G47Δ to metastatic breast cancer in the brain

“…6 The most common malignant tumors in the brain are metastases, with up to 50% of cancer patients eventually developing brain metastases. 9 Melanoma, while not the most common cancer, has the greatest likelihood to metastasize to the brain with B50% clinically diagnosed and up to 80% at autopsy. 10 In lung cancer, brain metastases are common with about 10% of patients presenting with small-cell lung cancer having brain metastases and rising to B40% at autopsy.…”