Mystery of the brain metastatic disease in breast cancer patients: improved patient stratification, disease prediction and targeted prevention on the horizon?

Abstract

The breast cancer (BC) diagnosis currently experiences the epidemic evolution with more than half of million deaths each year. Despite screening programmes applied and treatments available, breast cancer patients frequently develop distant metastases. The brain is one of the predominant sites of the metastatic spread recorded for more than 20% of BC patients, in contrast to the general population, where brain tumours are rarely diagnosed. Although highly clinically relevant, the brain tumour mystery in the cohort of breast cancer patients has not been yet adequately explained. This review summarises currently available information on the risk factors predicting brain metastases in BC patients to motivate the relevant scientific areas to explore the data/facts available and elucidate disease-specific mechanisms that are of a great clinical utility.

Inappropriate modeling of chronic and complex disorders: How to reconsider the approach in the context of predictive, preventive and personalized medicine, and translational medicine

“…Hence, Jaak Janssens beautifully stated the question as: "should we speak about breast cancers instead of cancer?" [32,33].…”

“…As stated by Janssens, "Should we speak about breast cancers instead of cancer?" [32,33]. Parallel to the personalized clinical approach, our disease models should be defined precisely.…”

“…As another example, it has been repeatedly shown that premenopausal women with breast cancer have a higher risk for brain metastasis development. Thus, the premenopausal status at the time of breast cancer diagnosis is considered as an additional risk factor for the brain metastatic lesions which were not reflected in animal models of breast cancer [32,38]. It is time to ask how could we rely on the results of animal experiments with such significant inter-and intra-species discrepancies.…”

Feeling cold and other underestimated symptoms in breast cancer: anecdotes or individual profiles for advanced patient stratification?

“…Although, those cases are published generally by case reports, just some weeks ago, we have released a review article titled 'Mystery of the brain metastatic disease in breast cancer patients: Improved patient stratification, disease prediction and targeted prevention on the horizon?' [9]. The article analyses important aspects of the interrelation between particularly aggressive BC subtypes and brain metastasis: on one side, primary brain tumour is a rare disorder responsible for high mortality and morbidity: relatively low prevalence in general population is ranging between 12.0 and 15.5 per 100,000 person-year for different countries and regions worldwide [10][11][12][13].…”

“…Although highly clinically relevant, this mystery has not been yet adequately explained. Contextually, the paper concludes that innovative multi-level diagnostic approaches are needed to predict BC patients at high risk for the potential development of brain metastasis [9].…”