scholarly journals LONG-LASTING CONTROL OF HER-2 POSITIVE DISSEMINATED BREAST CANCER IN A REPRODUCTIVE AGED PATIENT

2021 ◽  
Vol 20 (3) ◽  
pp. 158-164
Author(s):  
A. V. Vazhenin ◽  
N. V. Voroshina ◽  
O. S. Tereshin ◽  
N. S. Dubrovskaya
Keyword(s):  
Breast Cancer ◽  
Social Activity ◽  
Whole Brain Radiotherapy ◽  
First Year ◽  
Low Grade ◽  
Significant Prognostic Factor ◽  
Brain Radiotherapy ◽  
Multiple Metastases ◽  
Her 2

Background. Breast cancer ranks as the second most common cancer (14.9 %) and the most common female cancer (20.9 %) in Russia. at the time of diagnosis, 11.0 % of patients have already developed metastases, and 10.3 % of patients die within the first year of diagnosis from disease progression. distant metastasis is the leading cause of death from breast cancer, and brain metastasis is a significant prognostic factor for poor survival.Case description. We report the case of a long-lasting control of advanced breast cancer with brain metastases in a 32-year-old woman. low grade tubular breast carcinoma was histologically confirmed. immunohistochemical study: eR-ts-4 points, PR-ts – 3 points, Her-2 positive, Ki67 – 35.0 %. BRCa1 5382ins C mutation was not detected. the long-term use of therapy with lapatinib and capecitabine was described.Conclusion. this case demonstrates the feasibility of long-term (31 months) control over Her-2 positive disseminated breast cancer with multiple metastases to the brain and bones, while maintaining the quality of life and social activity of a young patient. despite the risks associated with whole brain radiotherapy, no cognitive impairment was observed. therapy with lapatinib and capecitabine was effective for 28 months with good tolerance.

scholarly journals Clinical outcomes in patients with brain metastases from breast cancer treated with single-session radiosurgery or whole brain radiotherapy

2016 ◽  
Vol 125 (Supplement_1) ◽  
pp. 26-30 ◽  
Author(s):  
Michael Mix ◽  
Rania Elmarzouky ◽  
Tracey O'Connor ◽  
Robert Plunkett ◽  
Dheerendra Prasad
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Median Survival ◽  
Tumor Volume ◽  
Whole Brain Radiotherapy ◽  
Metastatic Tumor ◽  
Whole Brain ◽  
Receptor Status ◽  
Brain Radiotherapy ◽  
Her 2

OBJECTIVEGamma Knife radiosurgery (GKRS) is used to treat brain metastases from breast cancer (BMB) as the sole treatment or in conjunction with tumor resection and/or whole brain radiotherapy (WBRT). This study evaluates outcomes in BMB based on treatment techniques and tumor biological features.METHODSThe authors reviewed all patients treated with BMB between 2004 and 2014. Patients were identified from a prospectively collected radiosurgery database and institutional tumor registry; 214 patients were identified. Data were collected from aforementioned sources and supplemented with chart review where needed. Independent radiological review was performed for all available brain imaging in those treated with GKRS. Survival analyses are reported using Kaplan-Meier estimates.RESULTSDuring the 10-year study period, 214 patients with BMB were treated; 23% underwent GKRS alone, 46% underwent a combination of GKRS and WBRT, and 31% underwent WBRT alone. Median survival after diagnosis of BMB in those treated with GKRS alone was 21 months, and in those who received WBRT alone it was 3 months. In those treated with GKRS plus WBRT, no significant difference in median survival was observed between those receiving WBRT upfront or in a salvage setting following GKRS (19 months vs 14 months, p = 0.63). The median survival of patients with total metastatic tumor volume of ≤ 7 cm3 versus > 7 cm3 was 20 months vs 7 months (p < 0.001). Human epidermal growth factor receptor-2 (Her-2) positively impacted survival after diagnosis of BMB (19 months vs 12 months, p = 0.03). Estrogen receptor status did not influence survival after diagnosis of BMB. No difference was observed in survival after diagnosis of BMB based on receptor status in those who received WBRT alone.CONCLUSIONSIn this single-institution series of BMB, the addition of WBRT to GKRS did not significantly influence survival, nor did the number of lesions treated with GKRS. Survival after the diagnosis of BMB was most strongly affected by Her-2 positivity and total metastatic tumor volume.

CNS Metastases in Breast Cancer

2004 ◽  
Vol 22 (17) ◽  
pp. 3608-3617 ◽  
Author(s):  
Nancy U. Lin ◽  
Jennifer R. Bellon ◽  
Eric P. Winer
Keyword(s):  
Breast Cancer ◽  
Current Knowledge ◽  
Case Reports ◽  
Case Series ◽  
Metastatic Breast ◽  
Whole Brain Radiotherapy ◽  
Cns Metastases ◽  
Brain Radiotherapy ◽  
Multiple Metastases ◽  
Therapy Studies

As systemic therapy of metastatic breast cancer improves, CNS involvement is becoming a more widespread problem. This article summarizes the current knowledge regarding the incidence, clinical presentation, diagnosis, prognosis, and treatment of CNS metastases in patients with breast cancer. When available, studies specific to breast cancer are presented; in studies in which many solid tumors were evaluated together, the proportion of patients with breast cancer is noted. On the basis of data from randomized trials and retrospective series, neurosurgery and stereotactic radiosurgery (SRS) may prolong survival in patients with single brain metastases. The treatment of multiple metastases remains controversial, as does the routine use of whole-brain radiotherapy (WBRT) after either surgery or SRS. Although it is widely assumed that chemotherapy is of limited benefit, data from case series and case reports suggest otherwise. WBRT, neurosurgery, SRS, and medical therapy each have a role in the treatment of CNS metastases; however, neurologic symptoms frequently are not fully reversible, even with appropriate therapy. Studies specifically targeted toward this group of patients are needed.

scholarly journals CTNI-01. EFFECT OF STEREOTACTIC RADIOSURGERY COMPARED TO WHOLE-BRAIN RADIOTHERAPY FOR LIMITED BRAIN METASTASIS ON LONG TERM COGNITION AND QUALITY OF LIFE: A POOLED ANALYSIS OF RANDOMIZED CLINICAL TRIALS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii40-ii41
Author(s):  
Joshua Palmer ◽  
Brett Klamer ◽  
Karla Ballman ◽  
Paul Brown ◽  
Jane Cerhan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Clinical Trials ◽  
Whole Brain Radiotherapy ◽  
Pooled Analysis ◽  
Cognitive Outcomes ◽  
Phase Iii ◽  
Brain Radiotherapy ◽  
Over Time

Abstract PURPOSE We investigated the long term impact of SRS and WBRT in two large prospective phase III trials. METHODS Patients with 1–4 BMs +/- resection were randomized to SRS or WBRT. Cognitive deterioration was a drop of &gt;1 standard deviation from baseline in &gt;2/6 cognitive measures (CM). Quality of life (QOL) scores were scored 0–100 point scale. CM and QOL scores were modeled using baseline adjusted Linear Mixed Models (LMM) with uncorrelated random intercept for subject and random slopes for time. Differences over time between groups and the effect of &gt;2 cognitive scores with &gt;2 SD change from baseline were assessed. RESULTS 88 patients were included with median follow up of 24 months. We observed decreasing CM over time (SRS: 4/6; WBRT: 5/6). Mean CM was significantly higher in SRS for Total recall and Delayed Recall at 3, 6, 9, 12 months. More patients in WBRT arm declined 1 SD in &gt;1 and &gt;2 CM at the 3, 6, 9, and 12 months. A 1 SD decline in &gt;3 CM at 1 year was 21% SRS vs 47% WBRT (p=0.02). SRS had fewer patients with a 2 SD decline in &gt;1 CM at every time point. SRS had fewer patients with a 2 SD decline at &gt;2 and &gt;3 CM. WBRT had lower QOL at 3 months, but switched to SRS having lower QOL at 24 months for PWB, EWB, FWB, FactG, BR, and FactBR (p&lt; 0.05). A 2 SD decline in cognition decreased mean FWB by 6.4 units (95% CI: -11, -1.75; p=0.007) and decreased QOL by 5.1 units (95% CI: -7.7, -2.5; p&lt; 0.001). CONCLUSIONS We report the first pooled prospective study demonstrating the long term outcomes of patients with BMs after cranial radiation. WBRT was associated with worse cognitive outcomes. Impaired cognition is associated with worse QOL.

scholarly journals Current treatment of patients with multiple brain metastases

2000 ◽  
Vol 9 (2) ◽  
pp. 1-5 ◽  
Author(s):  
Steven D. Chang ◽  
John R. Adler
Keyword(s):  
Brain Metastases ◽  
Treatment Options ◽  
Whole Brain Radiotherapy ◽  
Mass Effect ◽  
Current Treatment ◽  
Rapid Reduction ◽  
Multiple Brain Metastases ◽  
Brain Radiotherapy ◽  
Multiple Metastases ◽  
Difficult Challenge

The management of patients with multiple brain metastases remains a difficult challenge for neurosurgeons. This patient population has a poor prognosis when compared with those harboring a solitary brain metastasis, and historically treatment has generally consisted of administering whole-brain radiotherapy once the diagnosis of multiple brain metastases is made. Resection can be useful in a subset of patients with multiple metastases in whom one or two of the lesions are symptomatic, as this may provide rapid reduction of mass effect and edema. Furthermore, the authors of recent studies have shown that stereotactic radiosurgery can be used in certain patients with multiple brain metastases as part of the treatment regimen. In this review the authors outline the treatment options and indications as well as a management strategy for the treatment of patients with multiple brain metastases.

scholarly journals Long-term prognostic significance of HER-2/neu in untreated node-negative breast cancer depends on the method of testing

2005 ◽  
Vol 7 (2) ◽  
Author(s):  
Marcus Schmidt ◽  
Barbara Lewark ◽  
Nikolai Kohlschmidt ◽  
Christiane Glawatz ◽  
Erik Steiner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Significance ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Her 2

scholarly journals Study on Estrogen Receptor, Progesterone Receptor and HER-2/ neu Expression Pattern by Immunohistochemistry in 87 cases of Invasive Breast Cancer

KYAMC Journal ◽  
2017 ◽  
Vol 5 (1) ◽  
pp. 436-443
Author(s):  
Md Shahadat Hossain ◽  
Ferdousy Begum ◽  
Ashim Ranjan Barua
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Progesterone Receptor ◽  
Expression Pattern ◽  
Invasive Breast Cancer ◽  
Standard Procedure ◽  
Low Grade ◽  
Positive Reactivity ◽  
Her 2 ◽  
Grade Tumour

Background: Now a day's determination of estrogen receptor (ER), progesterone receptor (PR) and HER-2/neu expression pattern by immunohistochemistry in invasive breast cancer have become the standard procedure for breast cancer management.Objective: To see the expression pattern of estrogen receptor, progesterone receptor and HER-2/neu in Bangladeshi women with invasive breast carcinoma.Method: This cross sectional study was performed in 87 cases of invasive breast cancer. Estrogen receptor (ER), Progesterone receptor (PR) and HER-2/neu expression pattern were assessed by immunohistochemistry using monoclonal antibodies for detecting estrogen and progesterone receptors, and polyclonal antibody for detecting HER-2/neu.Results: All the cases were graded according to Bloom-Richardson grading system. Of those, Grade I tumour was 18 (20.69%), Grade II tumour was 58 (66.67%) and Grade III tumour was 11(12.64%). Both ER and PR positive reactivity were same and it was found 65 (74.71%) and HER-2/neu reactivity pattern were found negative in 59 (67.82%) cases and positive in 28 (32.18%) cases. A statistically significant correlation was found between the expression of ER and low grade tumour (p=0.011) and combined estrogen and progesterone receptor positive reactivity with low grade tumour (p=0.002).Conclusion: ER, PR and HER-2/neu expression do not correlated with each other, so it is recommended that each test should be independently determined by immunohistochemistry in all cases of invasive breast cancer. All equivocal cases of HER-2/neu (score 2+) should be analyzed by FISH technique to find out the percentage of real score.KYAMC Journal Vol. 5, No.-1, Jul 2014, Page 436-443

Concurrent capecitabine and whole-brain radiotherapy for treatment of brain metastases in breast cancer patients

2009 ◽  
Vol 93 (3) ◽  
pp. 379-384 ◽  
Author(s):  
Cyrus Chargari ◽  
◽  
Youlia M. Kirova ◽  
Véronique Diéras ◽  
Pablo Castro Pena ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Whole Brain Radiotherapy ◽  
Breast Cancer Patients ◽  
Whole Brain ◽  
Brain Radiotherapy
Sign in / Sign up

Export Citation Format

Share Document