Survival of breast cancer patients with meningeal carcinomatosis

Gauthier, H.; Guilhaume, M.N.; Bidard, François-Clément; Pierga, Jean‐Yves; Girre, V.; Cottu, Paul; Laurence, Valérie; Livartowski, Alain; Mignot, L.; Dièras, Véronique

doi:10.1093/annonc/mdq232

Cited by 150 publications

(161 citation statements)

References 15 publications

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“…When comparing the frequency of molecular subtypes in LM with that in the whole breast cancer population, the results indicate that TN patients exhibit a higher predisposition for LM than the luminal A subtype. Two previous studies reported TN breast cancer frequencies of 39 and 21% in cohorts of 61 and 91 breast cancer patients, respectively (5,10).…”

Section: Predilection Of Histological and Biological Breast Cancer Sumentioning

confidence: 94%

“…Metastasis to the leptomeninges is most common in patients diagnosed with the invasive lobular carcinoma histological subtype of breast cancer (5,15). While the rate of lobular carcinoma varies between 17 and 28% among patients initially diagnosed with breast cancer, studies have revealed that ≤35% of patients with LM exhibit lobular carcinoma (Table II).…”

Section: Predilection Of Histological and Biological Breast Cancer Sumentioning

confidence: 99%

“…Autopsy data from metastatic breast cancer patients has demonstrated that the estimated incidence of LM in infiltrating lobular breast carcinoma is 14% compared with 1% in cases of infiltrating ductal breast carcinoma (18). Breast cancer subtypes are considered to exhibit particular patterns of metastasis, which leads to distinct survival rates following relapse (5). Previous studies have analysed the incidence and prognostic implications of LM in the following four molecular subtypes: Luminal A [estrogen receptor (ER)/progesterone receptor (PR) positive, human epidermal growth factor receptor 2 (HER2) negative]; luminal B (ER/PR positive, HER2 positive); HER2 positive (ER/PR negative, HER2 positive); and TN (ER/PR negative, HER2 negative) (7,10,13).…”

Section: Predilection Of Histological and Biological Breast Cancer Sumentioning

confidence: 99%

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Leptomeningeal carcinomatosis as the primary presentation of relapse in breast cancer

et al. 2016

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Abstract. Leptomeningeal metastasis (LM) is an uncommon presentation of relapse in breast cancer, which is associated with poor clinical outcomes and poor prognosis. Notably, LM most commonly occurs in breast cancer. The aim of the present review was to investigate the occurrence of LM as the primary presentation of relapse following remission in breast cancer patients and to determine whether specific histological subtypes are predisposed to meningeal metastases. In addition, the present review evaluated whether patients presenting with LM as the primary site of relapse exhibit differences in survival when compared with patients exhibiting metastasis to other sites. Cross-sectional studies have demonstrated that LM is commonly associated with other sites of distant metastasis including lung, liver and bone metastases. The histological breast cancer subtype most commonly associated with LM was invasive lobular carcinoma, while triple-negative breast cancer patients appear to be predisposed to the development of LM when considering the overall prevalence of histological breast cancer subtypes. At present, data regarding LM as the primary site of relapse are limited due to its rarity as the first site of metastasis in breast cancer. Case-controlled studies are required to investigate the incidence of LM as the primary site of recurrence in breast cancer patients as this would enable treatment standardization and identification of prognostic factors for improved survival.

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Section: Predilection Of Histological and Biological Breast Cancer Sumentioning

confidence: 94%

Section: Predilection Of Histological and Biological Breast Cancer Sumentioning

confidence: 99%

Section: Predilection Of Histological and Biological Breast Cancer Sumentioning

confidence: 99%

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Leptomeningeal carcinomatosis as the primary presentation of relapse in breast cancer

et al. 2016

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“…Bu sebeple MRG'nin LP'den önce yapılması önerilir (15). MRG'de patoloji saptanmamış olması LM tanı-sını ekarte ettirmez (duyarlılık %20-91) (16,17,18). BT'nin tanıda değeri kı-sıtlıdır, MRG çekilemeyen hastalarda tercih edilebilir (duyarlılık %20) (19 …”

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Menenjit ile karıșan leptomeningeal metastaz olgu sunumu

Fidan

2017

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Bu olgu sunumunda bir aydır devam edip son iki haftadır șiddeti artan baș ağrısı, bulantı, kusma, ıșığa intolerans șikayetleri olan 52 yașında bir kadın hasta sunulmaktadır. Bir yıl önce meme kanseri tanısı alan hastanın kemoterapi ve radyoterapi tedavisi 6 ay önce tamamlanmıștır. Klinik, lomber ponksiyon ve ilk magnetik rezonans görüntüleme (MRG) bulguları ile meneningoensefalit düșünülerek empirik antibiyoterapi bașlanmıștır. Antibiyotik tedavisine yanıt alınamadığı için beyin omurilik sıvısında (BOS) sitolojik inceleme yapılmıș ve tekrarlanan MRG'de serebellumda lineer tarzda leptomeningeal tutulum görülmüștür. Klinik bulgular ve radyolojik görün-tüleme sonucu ile meme kanserine bağlı leptomeningeal metastaz (LM) tanısı konulmuștur. Üç hafta yoğun bakım ünitesinde (YBÜ) takip edilen hasta kaybedilmiștir. Çok farklı klinik tablolar olușturabildiğinden dolayı tanıda gecikmeler yașanmaktadır. Bu vaka LM'in, meningoensefalit ile karıșabileceğini göstermesi bakımından dikkat çekicidir.Anahtar Sözcükler: Bakteriyel menenjit, Leptomeningeal metastaz, AteșIn this case report 52 years old woman having severe headache for two weeks, nausea, vomiting and intolerence to light has been reported. A year ago she was diagnosed as breast cancer; chemotherapy and radiotherapy treatment has finished 6 months ago. With findings of lomber puncture and magnetic resonance imaging (MRI), meningoencephalopathies has considered and ampiric antibiotic treatment has begun. In spite of appropriate antibiotics our case consciousness state has not changed so cytologic analyses of cerebrospinal fluid (CSF) and second MRI has been performed and reportes as lineer leptomeningeal infiltration at cerebellum. With clinical symptoms and MRI findings our case was diagnosed as leptomeningeal metastases (LM). Three weeks later the patient died at intensive care unit (ICU). Diagnosis of LM is difficult because it can be presented in different clinical situations. So some patients can diagnosed lately. This case is important in the cause of showing LM can be misdiagnosed as meningoencephalopathies.

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“…No entanto, após a realização de ajustamento para os fatores de confundimento identificados, apenas a origem do tumor primitivo mostrou significância estatística, estando a mama associado a melhor prognóstico. Este achado é suportado por outras séries da literatura 5,7,8,19 e poderá justificar as diferenças encontradas na análise não ajustada no que se refere ao género.…”

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Tratamento de Carcinomatose Meníngea por Quimioterapia Intratecal Através de Catéter Reservatório de Ommaya: Experiência de um Centro Neurocirúrgico

et al. 2016

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RESUMOIntrodução: A carcinomatose meníngea consiste na infiltração de células tumorais ao longo das leptomeninges e espaço subaracnoideu, encontrando-se associada a uma sobrevida média de 2 -5 meses. As indicações sobre a modalidade mais adequada de tratamento permanecem tema de discussão, sendo fundamental um correto conhecimento da história natural da doença e da dualidade risco-benefício para uma decisão terapêutica interdisciplinar. Results: Twenty three patients were included (19 females, four males) with median age of 56.1 ± 2.2 years. The primary tumour was: breast -16 patients, lung -four patients, stomach, bladder and cervix -one patient each. No complications were seen (infection, intracranial haematoma or CSF fistula). The median survival was 26.4 ± 7.7 weeks, range between nine days and 118 weeks (21/23 patients). Male gender was related to poor prognosis in crude analysis (p value = 0.0032). Breast adenocarcinoma was related with better prognosis in adjust analysis (p value = 0.036, HR: 4.36 ± 3.06; 95% IC: 1.10 -17.25). Longer time between initial tumour and meningeal carcinomatosis diagnosis was related to a better outcome but without statistical significance. Discussion: Despite the low complication rate of Ommaya reservoir placement, the poor response to chemotherapy and the disease prognosis should be considered in patients with poor functional status. The relationship observed between the primary tumour and the overall survival supports that meningeal carcinomatosis should not be considered a disease by itself but always in the context of a systemic disease. The low incidence of breast cancer in male population might be related with it poorer prognosis. Conclusion: Meningeal carcinomatosis has a poor prognosis. Breast adenocarcinoma, longer time between initial tumour and meningeal carcinomatosis diagnosis, and age < 60 years were related with longer survival.

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Survival of breast cancer patients with meningeal carcinomatosis

Abstract: MC presents a poor prognosis, but 1-year survival rate was 25%. This score may become a useful tool for treatment decision and clinical trials.

Cited by 150 publications

References 15 publications

Leptomeningeal carcinomatosis as the primary presentation of relapse in breast cancer

Leptomeningeal carcinomatosis as the primary presentation of relapse in breast cancer

Menenjit ile karıșan leptomeningeal metastaz olgu sunumu

Tratamento de Carcinomatose Meníngea por Quimioterapia Intratecal Através de Catéter Reservatório de Ommaya: Experiência de um Centro Neurocirúrgico

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