Predictive factors for oligometastatic versus non-oligometastatic involvement of the central nervous system by brain metastases from breast cancer.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 123-123 ◽  
Author(s):  
S. Garg ◽  
J. C. Marsh ◽  
R. D. Rao ◽  
K. L. Griem
Keyword(s):  
Breast Cancer ◽  
Central Nervous System ◽  
Nervous System ◽  
Brain Metastases ◽  
Initial Diagnosis ◽  
Breast Cancer Patients ◽  
Cns Involvement ◽  
Cancer Subtypes ◽  
Oligometastatic Disease ◽  
The Central Nervous System

123 Background: To assess rates of oligometastatic (1-3 metastases) versus non-oligometastatic (4 or more) involvement of the central nervous system (CNS) from breast cancer and determine whether rates vary for different breast cancer subtypes. Methods: We reviewed records of 65 patients with brain metastases from breast cancer. Fisher’s Exact Test compared incidence of oligometastatic versus nonoligometastatic CNS involvement and presence of visceral metastatic disease between groups. Paired Student's t test compared mean age and interval from initial diagnosis to development of brain metastases. Results: 25 patients (38.5%) developed oligometastatic and 40 (61.5%) developed non-oligometastatic CNS disease. Subtypes predictive of oligometastatic disease included ER+ (p .04) and PR+ (p .008). Subtypes predictive of non-oligometastatic disease included HER2+ (p .05). HER2+ patients trended toward a lower incidence of visceral metastases compared to ER+ or PR+ patients (p .07). Non-oligometastatic and HER2+ patients developed brain metastases sooner after initial diagnosis (p .046 and .03, respectively). Conclusions: ER+ breast cancer patients are more likely to develop oligometastatic CNS involvement and may be excellent candidates for stereotactic radiosurgery (SRS) alone. HER+ patients are likely to develop non-oligometastatic CNS involvement and may be better treated initially with whole brain radiotherapy (WBRT) even with apparent initial oligometastatic CNS involvement.

Breast Cancer in the Central Nervous System: Multidisciplinary Considerations and Management

2017 ◽  
pp. 45-56 ◽  
Author(s):  
Nancy U. Lin ◽  
Laurie E. Gaspar ◽  
Riccardo Soffietti
Keyword(s):  
Breast Cancer ◽  
Central Nervous System ◽  
Nervous System ◽  
Brain Metastases ◽  
Multidisciplinary Treatment ◽  
Standards Of Care ◽  
Leptomeningeal Disease ◽  
Her2 Positive ◽  
Cancer Subtypes ◽  
New Findings

Breast cancer is the second most common primary tumor associated with central nervous system (CNS) metastases. Patients with metastatic HER2-positive or triple-negative (estrogen receptor (ER)–negative, progesterone receptor (PR)–negative, HER2-negative) breast cancer are at the highest risk of developing parenchymal brain metastases. Leptomeningeal disease is less frequent but is distributed across breast cancer subtypes, including lobular breast cancer. Initial treatment strategies can include surgery, radiation, intravenous or intrathecal chemotherapy, and/or targeted approaches. In this article, we review the epidemiology of breast cancer brain metastases, differences in clinical behavior and natural history by tumor subtype, and important considerations in the multidisciplinary treatment of these patients. We will highlight new findings that impact current standards of care, clinical controversies, and notable investigational approaches in clinical testing.

scholarly journals V6 PRIMROSE: A national trainee collaborative-led, multicentre prospective audit on the care of breast cancer patients with central nervous system disease in the UK

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Mark P Lythgoe ◽  
Vinton W T Cheng ◽  
Hayley S McKenzie ◽  
Amy Kwan ◽  
Apostolos Konstantis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Central Nervous System ◽  
Cancer Research ◽  
Nervous System ◽  
Brain Metastases ◽  
Central Nervous System Disease ◽  
Breast Cancer Patients ◽  
Prospective Audit ◽  
System Disease ◽  
The Uk

Abstract PRIMROSE A national trainee collaborative-led, multicentre prospective audit on the care of breast cancer patients with central nervous system disease in the UK Mark P Lythgoe1, Vinton WT Cheng2, Hayley S McKenzie3, Amy Kwan4, Apostolos Konstantis5, Ruichong Ma6, Pei J Teo7, Amanda Fitzpatrick8, Laura Woodhouse9 & Carlo Palmieri10 on behalf of the BNTRC† and PRIMROSE study group 1Imperial College Healthcare NHS Trust, London, 2Leeds Cancer Centre, Leeds, 3University of Southampton, Southampton, 4University of Sheffield, Sheffield, 5The Princess Alexandra NHS Trust, Harlow 6Oxford University Hospitals NHS Trust, Oxford, 7Worcestershire Acute Hospitals NHS Trust, Worcester, 8Institute of Cancer Research, London, 9The Christie NHS Foundation Trust, Manchester, 10University of Liverpool, Liverpool, †British Neurosurgical Trainee Research Collaborative Introduction Breast cancer is the commonest cancer in the UK and the 4th leading cause of cancer-related death. Breast cancer brain metastases (BCBM) are a poor prognostic indicator and associated with very poor survival and only a minority of patients survive >1 year despite oncological treatment. The rising prevalence of patients with BCBM represent an increasing unmet healthcare need. However, in the UK there is a paucity of data about prevalence, survival and management. Guidance on managing brain metastases is improving, however it is unclear how this has been applied in the context of BCBM and whether recommended standards are uniformly applied across the UK Methods PRIMROSE is a trainee collaborative-led initiative to estimate BCBM prevalence, assess current practice (comparing national/international standards) and determine long term outcomes/sequalae. Anonymised data is being pooled via secure REDCap database collating demographics, clinico-pathological information, prior treatment, BCBM treatment and other key variables. All UK hospitals can register, with recruitment driven by trainees via the UK Breast Cancer Trainees Research Collaborative Group and British Neurosurgical Trainee Research Collaborative. Senior oversight will be provided by a local consultant oncologist or neurosurgeon. Results Opened in Jan 2020, 180 datasets have been entered, despite significant disrupted due to COVID-19 from Feburary to May). Over 25 sites are open/in the process of joining. Trainee networks have been established in all regions of the UK with the exception of Yorkshire and The Humber, East of England and North East England. Promotion of the network has occurred at significant oncology conferences (e.g. San Antonio Breast Meeting, and National Cancer Research Institute). We plan to expand to all major UK neurosurgical and oncology centres by December 2020, with data collection completed by December 2021. Conclusions PRIMROSE demonstrates the utility of trainee collaborative networks in rapidly organising large-scale multicentre data collection to understand care of patients at a national level. Such information will be important for identifying current pactice and act as a benchmark for improving local service delivery for patients with BCBM.

scholarly journals Treatment of secondary central nervous system involvement in systemic aggressive B cell lymphoma using R-MIADD chemotherapy: a single-center study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuchen Wu ◽  
Xuefei Sun ◽  
Xueyan Bai ◽  
Jun Qian ◽  
Hong Zhu ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Involvement ◽  
Central Nervous System Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Cns Involvement ◽  
The Central Nervous System ◽  
Secondary Central Nervous System

Abstract Background Secondary central nervous system lymphoma (SCNSL) is defined as lymphoma involvement within the central nervous system (CNS) that originated elsewhere, or a CNS relapse of systemic lymphoma. Prognosis of SCNSL is poor and the most appropriate treatment is still undetermined. Methods We conducted a retrospective study to assess the feasibility of an R-MIADD (rituximab, high-dose methotrexate, ifosfamide, cytarabine, liposomal formulation of doxorubicin, and dexamethasone) regimen for SCNSL patients. Results Nineteen patients with newly diagnosed CNS lesions were selected, with a median age of 58 (range 20 to 72) years. Out of 19 patients, 11 (57.9%) achieved complete remission (CR) and 2 (10.5%) achieved partial remission (PR); the overall response rate was 68.4%. The median progression-free survival after CNS involvement was 28.0 months (95% confidence interval 11.0–44.9), and the median overall survival after CNS involvement was 34.5 months. Treatment-related death occurred in one patient (5.3%). Conclusions These single-centered data underscore the feasibility of an R-MIADD regimen as the induction therapy of SCNSL, further investigation is warranted.

Seven cases of breast cancer recurrence limited to the central nervous system without other visceral metastases

Breast Cancer ◽  
2000 ◽  
Vol 7 (2) ◽  
pp. 153-156 ◽  
Author(s):  
Hisato Higashi ◽  
Takashi Fukutomi ◽  
Toru Watanabe ◽  
Isamu Adachi ◽  
Masaru Narabayashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Central Nervous System ◽  
Nervous System ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Visceral Metastases ◽  
The Central Nervous System

scholarly journals Current management of brain metastases

2014 ◽  
Vol 33 (04) ◽  
pp. 347-351
Author(s):  
Pedro Tadao Hamamoto Filho ◽  
Vitor César Machado ◽  
Flávio Ramalho Romero ◽  
Luis Gustavo Ducati ◽  
Marco Antônio Zanini ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Metastases ◽  
Whole Brain Radiotherapy ◽  
Treatment Modalities ◽  
Current Management ◽  
Brain Radiotherapy ◽  
Recent Advances ◽  
The Central Nervous System ◽  
Treatment Surgery

AbstractBrain metastases are the most common tumors within the central nervous system. Recent advances on diagnosis and treatment modalities have allowed for longer survival. In this paper we review the indication of each modality of treatment: surgery, whole brain radiotherapy and stereotactic radiosurgery, as also recent advances on the knowledge of brain metastases biology that may improve the use of medical treatment and chemotherapy.

What Determines Primary Breast Cancer Patients' Hope to Recover

1998 ◽  
Vol 82 (3) ◽  
pp. 835-840
Author(s):  
Bert De Brabander ◽  
Pol Gerits ◽  
Robert Sacré ◽  
Jan Lamote
Keyword(s):  
Breast Cancer ◽  
Central Nervous System ◽  
Real Life ◽  
Plasma Samples ◽  
Breast Cancer Patients ◽  
Main Metabolite ◽  
Blood Samples ◽  
The Central Nervous System ◽  
Life Stressor ◽  
Na Depletion

The main purpose was to offer evidence for the hypothesis that the stronger an acute real life stressor, namely, hearing from the physician that one has breast cancer and that one has to undergo mastectomy, the greater the induced noradrenaline (NA) depletion in the central nervous system (CNS) and the more the pa-dent loses hope to recover. The data were derived from answers to interviews, questionnaires, and analyses of blood samples obtained from the patients on the day of admission to the hospital for a biopsy and 24 hours after the surgeon communicated the results of the biopsy to the patients. Analysis showed that a decline in 3-Methoxy 4-Hydroxy Methoxy 4-Hydroxy Phenylethylene Glycol (MHPG) concentration in blood plasma samples after being informed of the diagnosis is associated with less hope of recovery. MHPG is the main metabolite of CNS noradrenaline.

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