Whole-brain Radiation Therapy for Breast Cancer Patients with Dural Metastasis Without Concomitant Brain Metastasis and Leptomeningeal Metastasis

Sakaguchi, Masakuni; Maebayashi, Toshiya; Aizawa, Takuya; Ishibashi, Naoya

doi:10.21873/anticanres.13001

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…However, prognosis of patients with DM have rarely been reported. A previous study compared the clinical presentation of patients with DM alone with that of patients with BM/LMC, reporting that the median OS was 12 months for patients with DM and 7 months for those with BM/LMC [24]. Based on a previous report and our results, DM is not significantly associated with patient survival.…”

Section: Discussionsupporting

confidence: 55%

Dural Metastasis in Breast Cancer: MRI-Based Morphological Subtypes and Their Clinical Implications

Ahn,

Joo,

Park

et al. 2024

Cancer Res Treat

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Purpose This study aimed to investigate the clinical factors associated with breast cancer (BRCA) dural metastases (DMs), their impact on prognosis compared to brain parenchymal metastases (BPMs) alone, and differences between DM subtypes, aiming to inform clinical decisions.Materials and Methods We retrospectively analyzed 119 patients with BRCA with brain metastasis, including 91 patients with BPM alone and 28 patients with DM. Univariate and multivariate analyses were performed to compare the clinical characteristics between the two groups and within subtypes of DM. Overall survival after DM (OSDM) and the interval from DM to leptomeningeal carcinomatosis (LMC) were compared using Kaplan-Meier analysis.Results DM was notably linked with extracranial metastasis, luminal-like BRCA subtype (p=0.033), and skull metastases (p < 0.001). Multiple logistic regression revealed a strong association of DM with extracranial and skull metastases, but not with subtype or hormone receptor status. Patients with DM did not show survival differences compared with patients with BPM alone. In the subgroup analysis, nodular-type DM correlated with human epidermal growth factor receptor 2 status (p=0.044), whereas diffuse-type DM was significantly associated with a higher prevalence of the luminal-like subtype (p=0.048) and the presence of skull metastasis (p=0.002). Patients with diffuse DM did not exhibit a significant difference in OSDM but had a notably shorter interval from DM to LMC compared to those with nodular DM (p=0.049).Conclusion While the impact of DM on the overall prognosis of patients with BRCA is minimal, our findings underscore distinct characteristics and prognostic outcomes within DM subgroups.

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Section: Discussionsupporting

confidence: 55%

Dural Metastasis in Breast Cancer: MRI-Based Morphological Subtypes and Their Clinical Implications

Ahn,

Joo,

Park

et al. 2024

Cancer Res Treat

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“…Endometrial metastases from breast cancer tend to occur together synchronously with multi-organ metastases [5,13]. Despite treatment with adjuvant chemoradiation therapy after surgical resection, breast cancer is known to have high metastatic potential [5,13,32,39,40]. Among breast carcinomas, the invasive lobular type is most frequently associated with endometrial metastasis.…”

Section: Discussionmentioning

confidence: 99%

Endometrium-Limited Metastasis of Extragenital Malignancies: A Challenge in the Diagnosis of Endometrial Curettage Specimens

Choi

Joo

et al. 2020

Diagnostics

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Malignancies of extragenital origin very rarely metastasize to the uterine body. Endometrium-limited metastases may pose diagnostic challenges in endometrial curettage specimens as they may be misdiagnosed as primary endometrial tumors. We investigated the clinicopathological characteristics of seven cases with endometrial-limited metastases from carcinomas of the nasopharynx (n = 1), breast (n = 2), colon (n = 2), stomach (n = 1), and appendix (n = 1). The patients’ ages ranged from 36 to 71 (mean: 55.4) years. None of the patients had a remarkable gynecological history, and the presenting sign in all cases was abnormal uterine bleeding. Although myometrial involvement was absent, multiple metastases were already present in extrauterine locations such as the lung, liver, bone, abdominopelvic peritoneum, and omentum. All patients underwent ultrasonographic examination prior to endometrial curettage. The histologies of the endometrial metastases identified from the curettage specimens were identical to those of the corresponding primary tumors. Ancillary tests including immunostaining and Epstein–Barr virus-encoded RNA in situ hybridization confirmed the extragenital origin. Endometrium-limited metastases from extragenital malignancies are extremely rare. They present with abnormal vaginal bleeding and mimic endometrial carcinomas of endometrioid or poorly differentiated types. Since their clinical presentations and histological features are similar to those of primary endometrial tumors, pathologists should consider the possibility of metastases while evaluating endometrial curettage specimens obtained from patients with a history of extragenital malignancies.

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“…A retrospective review of 122 patients with dural metastases reported that although not statistically significant, radiation therapy tended to prolong the survival of patients [1]. Additionally, in a report of eight breast cancer patients with dural metastases who received whole-brain irradiation, no deterioration was observed in any of the patients [12]. In our patient, chemotherapy was given priority over radiotherapy since the dural metastases were partial and there were no symptoms of the central nervous system being affected at the time of diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Rapid Progression of Intracranial Dural Metastases in a Patient with Carcinoma of Unknown Primary Site

et al. 2019

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Dural metastases are uncommon in cancer patients, but can have as much of an effect on the lives of patients as brain metastases. Dural metastases are most commonly associated with primary cancers of the breast, prostate, and lung, and it is rare that the primary site of the tumor is unknown. In this study, we encountered a 51-year-old woman who had developed multiple bone tumors, with no known primary cancer lesion. A tumor biopsy of the sacral bone revealed non-keratinizing squamous cell carcinoma; the patient was therefore diagnosed as having multiple bone metastases of an unknown primary cancer. Magnetic resonance imaging revealed cranial metastases and partial thickening of the dura with suspected dura metastases. Platinum-based chemotherapy reduced the bone metastases and the thickened dura. However, as resistance to chemotherapy developed, invasions progressed rapidly and diffusely throughout the dura. This was accompanied by the development of dysarthria, visual impairments, and delirium. The patient died 10 months after being diagnosed with dural metastases. This report provides information on the clinical course and prognosis of patients with dural metastases of unknown primary cancer. Furthermore, it may help to construct a treatment strategy for dural metastases.

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Whole-brain Radiation Therapy for Breast Cancer Patients with Dural Metastasis Without Concomitant Brain Metastasis and Leptomeningeal Metastasis

Cited by 5 publications

References 15 publications

Dural Metastasis in Breast Cancer: MRI-Based Morphological Subtypes and Their Clinical Implications

Dural Metastasis in Breast Cancer: MRI-Based Morphological Subtypes and Their Clinical Implications

Endometrium-Limited Metastasis of Extragenital Malignancies: A Challenge in the Diagnosis of Endometrial Curettage Specimens

Rapid Progression of Intracranial Dural Metastases in a Patient with Carcinoma of Unknown Primary Site

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