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Breast cancer and leptomeningeal disease (LMD): hormone receptor status influences time to development of LMD and survival from LMD diagnosis

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Abstract

Leptomeningeal disease (LMD) occurs in 5 % of breast cancer patients. The aim of this study was to identify risk factors related to survival and time to development of LMD in breast cancer patients. A retrospective analysis of breast cancer patients with LMD, evaluated in MDACC between 1995 and 2011. 103 patients with diagnosis of breast cancer and LMD were identified (one male). The median age at LMD diagnosis was 49.2 years. 78.2 % had invasive ductal carcinoma. Hormone receptors (HRs) were positive in 55.3 % of patients, 47.4 % were human epidermal growth factor receptor 2-positive and 22.8 % were triple negative. 52 % of the patients were treated with WBRT, 19 % with spinal radiation, 36 % with systemic chemotherapy and 55 % with intrathecal chemotherapy. Estimated median overall survival from time of breast cancer diagnosis was 3.66 years. Median survival from time of LMD diagnosis was 4.2 months. Time from breast cancer diagnosis to LMD was 2.48 years. In multivariate analysis, HR status and stage at diagnosis were significantly associated with time to LMD diagnosis (p < 0.05). In triple negative patients, time to LMD was shorter. In patients who were HR positive, time to LMD was longer. Survival from LMD diagnosis was significantly associated with both treatment, as well as positive HR status (multivariate analysis p < 0.05). In conclusion LMD has dismal prognosis in breast cancer patients. HR status contributes to time to LMD diagnosis and survival from LMD diagnosis. The impact of treatment aimed at LMD cannot be ascertained in our retrospective study due to the inherent bias associated with the decision to treat.

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References

  1. Siegel R, Ward E, Brawley O, Jemal A (2011) Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 61(4):212

    Article  PubMed  Google Scholar 

  2. Kennecke H, Yerushalmi R, Woods R, Cheang MC, Voduc D, Speers CH, Nielsen TO, Gelmon K (2010) Metastatic behavior of breast cancer subtypes. J Clin Oncol 28(20):3271–3277

    Article  PubMed  Google Scholar 

  3. Chamberlain MC (1998) Leptomeningeal metastases: a review of evaluation and treatment. J Neurooncol 37(3):271–284

    Article  PubMed  CAS  Google Scholar 

  4. Grewal J, Saria MG, Kesari S (2012) Novel approaches to treating leptomeningeal metastases. J Neurooncol 106(2):225–234

    Article  PubMed  Google Scholar 

  5. Kesari S, Batchelor TT (2003) Leptomeningeal metastases. Neurol Clin 21(1):25–66

    Article  PubMed  Google Scholar 

  6. Gleissner B, Chamberlain MC (2006) Neoplastic meningitis. Lancet Neurol 5:443–452

    Article  PubMed  Google Scholar 

  7. Chamberlain MC (2008) Neoplastic meningitis. Curr Neurol Neurosci Rep 8:249–258

    Article  PubMed  Google Scholar 

  8. Grossman SA, Krabak MJ (1999) Leptomeningeal carcinomatosis. Cancer Treat Rev 25(2):103–119

    Article  PubMed  CAS  Google Scholar 

  9. Tsukada Y, Fouad A, Pickren JW et al (1983) Central nervous system metastasis from breast carcinoma. Cancer 52:2349–2354

    Article  PubMed  CAS  Google Scholar 

  10. Lin NU, Bellon JR, Winer EP (2004) CNS metastases in breast cancer. J Clin Oncol 22(17):3608–3617

    Article  PubMed  Google Scholar 

  11. Slimane K, Andre F, Delaloge S, Dunant A, Perez A, Grenier J, Massard C, Spielmann M (2004) Risk factors for brain relapse in patients with metastatic breast cancer. Ann Oncol 15(11):1640–1644

    Article  PubMed  CAS  Google Scholar 

  12. Hicks DG, Short SM, Prescott NL, Tarr SM, Coleman KA, Yoder BJ, Crowe JP, Choueiri TK, Dawson AE, Budd GT, Tubbs RR, Casey G (2006) Weil RJ Breast cancers with brain metastases are more likely to be estrogen receptor negative, express the basal cytokeratin CK5/6, and overexpress HER2 or EGFR. Am J Surg Pathol 30(9):1097–1104

    Article  PubMed  Google Scholar 

  13. de Azevedo CR, Cruz MR, Chinen LT, Peres SV, Peterlevitz MA, de Azevedo Pereira AE, Fanelli MF, Gimenes DL (2011) Meningeal carcinomatosis in breast cancer: prognostic factors and outcome. J Neurooncol 104(2):565–572

    Article  PubMed  Google Scholar 

  14. Boogerd W, Hart AAM, Sande JJV, Engelsman E (1991) Meningeal carcinomatosis in breast cancer. Cancer 15:1685–1695

    Article  Google Scholar 

  15. Rudnicka H, Niwińska A, Murawska M (2007) Breast cancer leptomeningeal metastasis—the role of multimodality treatment. J Neurooncol 84:57–62

    Article  PubMed  Google Scholar 

  16. Jayson GC, Howell A, Harris M et al (1994) Carcinomatous meningitis in breast cancer: an aggressive disease variant. Cancer 74:3135–3141

    Article  PubMed  CAS  Google Scholar 

  17. Torrejón D, Oliveira M, Cortes J, Sanchez-Olle G, Gómez P, Bellet M, Saura C, Peg V, Rovira A, Di Cosimo S (2012) Implication of breast cancer phenotype for patients with leptomeningeal carcinomatosis. Breast. doi:10.1016/j.breast.2012

    PubMed  Google Scholar 

  18. Gauthier H, Guilhaume MN, Bidard FC et al (2010) Survival of breast cancer patients with meningeal carcinomatosis. Ann Oncol. doi:10.1093/annonc/mdq232

    Google Scholar 

  19. Sperduto PW, Kased N, Roberge D, Chao ST, Shanley R, Luo X, Sneed PK, Suh J, Weil RJ, Jensen AW, Brown PD, Shih HA, Kirkpatrick J, Gaspar LE, Fiveash JB, Chiang V, Knisely JP, Sperduto CM, Lin N, Mehta M (2013) The effect of tumor subtype on the time from primary diagnosis to development of brain metastases and survival in patients with breast cancer. J Neurooncol. doi:10.1007/s11060-013-1083-9

    PubMed  Google Scholar 

  20. Fleming ID, Cooper JS, Henson DE et al (eds) (1997) AJCC cancer staging manual, 5th edn. Lippincott-Raven, Philadelphia

    Google Scholar 

  21. Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL (1987) Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 235(4785):177–182

    Article  PubMed  CAS  Google Scholar 

  22. Altundag K, Bondy ML, Mirza NQ, Kau SW, Broglio K, Hortobagyi GN, Rivera E (2007) Clinicopathologic characteristics and prognostic factors in 420 metastatic breast cancer patients with central nervous system metastasis. Cancer 110(12):2640–2647

    Article  PubMed  CAS  Google Scholar 

  23. Harstad L, Kenneth R, Groves MD (2008) Prognostic factors and outcomes in patients with leptomeningeal melanomatosis. Neuro Oncol 10(6):1010–1018

    Article  PubMed  Google Scholar 

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Conflict of interest

S. Yust-Katz, P. Garciarena, D. Liu, Y. Yuan, N. Ibrahim and M Penas-Prado: No conflict of interest. M. Groves: Research support: Merck, Celldex, Genentech, GSK, Honoraria: Merck, Sanofi-Aventis, Genentech. Advisory board: Sanofi-Aventis, Genentech. Speakers bureau: Enzon.

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Authors and Affiliations

  1. Department of Neuro-Oncology, MD Anderson Cancer Center, Holcombe St., Houston, TX, 1515, USA

    S. Yust-Katz, P. Garciarena, M. Penas-Prado & M. D. Groves

  2. Department of Biostatistics, MD Anderson Cancer Center, Holcombe St., Houston, TX, 1515, USA

    D. Liu & Y. Yuan

  3. Breast Medical Oncology, MD Anderson Cancer Center, Holcombe St., Houston, TX, 1515, USA

    N. Ibrahim

  4. Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel

    R. Yerushalmi

  5. Texas Oncology Director, Austin Brain Tumor Center, 901 W. 38th St., Suite 200, Austin, TX, 78705, USA

    M. D. Groves

Authors
  1. S. Yust-Katz
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  2. P. Garciarena
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  3. D. Liu
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  4. Y. Yuan
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  5. N. Ibrahim
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  6. R. Yerushalmi
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  7. M. Penas-Prado
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  8. M. D. Groves
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Correspondence to S. Yust-Katz.

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Yust-Katz, S., Garciarena, P., Liu, D. et al. Breast cancer and leptomeningeal disease (LMD): hormone receptor status influences time to development of LMD and survival from LMD diagnosis. J Neurooncol 114, 229–235 (2013). https://doi.org/10.1007/s11060-013-1175-6

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  • DOI: https://doi.org/10.1007/s11060-013-1175-6

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