Journal of Neuro-Oncology

, Volume 127, Issue 3, pp 407–414 | Cite as

Brain metastasis in breast cancer: a comprehensive literature review

  • Rezvan Rostami
  • Shivam Mittal
  • Pooya Rostami
  • Fattaneh Tavassoli
  • Bahman Jabbari
Topic Review


This comprehensive review provides information on epidemiology, size, grade, cerebral localization, clinical symptoms, treatments, and factors associated with longer survival in 14,599 patients with brain metastasis from breast cancer; the molecular features of breast cancers most likely to develop brain metastases and the potential use of these predictive molecular alterations for patient management and future therapeutic targets are also addressed. The review covers the data from 106 articles representing this subject in the era of modern neuroimaging (past 35 years). The incidence of brain metastasis from breast cancer (24 % in this review) is increasing due to advances in both imaging technologies leading to earlier detection of the brain metastases and introduction of novel therapies resulting in longer survival from the primary breast cancer. The mean age at the time of breast cancer and brain metastasis diagnoses was 50.3 and 48.8 years respectively. Axillary node metastasis was noted in 32.8 % of the patients who developed brain metastasis. The median time intervals between the diagnosis of breast cancer to identification of brain metastasis and from identification of brain metastasis to death were 34 and 15 months, respectively. The most common symptoms experienced in patients with brain metastasis consisted of headache (35 %), vomiting (26 %), nausea (23 %), hemiparesis (22 %), visual changes (13 %) and seizures (12 %). A majority of the patients had multiple metastases (54.2 %). Cerebellum and frontal lobes were the most common sites of metastasis (33 and 16 %, respectively). Of the primary tumors for which biomarkers were recorded, 37 % were estrogen receptor (ER)+, 41 % ER−, 36 % progesterone receptor (PR)+, 34 % PR−, 35 % human epithelial growth factor receptor 2 (HER2)+, 41 % HER2−, 27 % triple negative and 18 % triple positive (TP). Treatment in most patients consisted of a multimodality approach often with two or more of the following: whole brain radiation therapy (52 %), chemotherapy (51 %), stereotactic radiosurgery (20 %), surgical resection (14 %), trastuzumab (39 %) for HER2 positive tumors, and hormonal therapy (34 %) for ER and/or PR positive tumors. Factors that had an impact on prognosis included grade and size of the tumor, multiple metastases, presence of extra-cranial metastasis, triple negative or HER2+ biomarker status, and high Karnovsky score. Novel therapies such as application of agents to reduce tumor angiogenesis or alter permeability of the blood brain barrier are being explored with preliminary results suggesting a potential to improve survival after brain metastasis. Other potential therapies based on genetic alterations in the tumor and the microenvironment in the brain are being investigated; these are briefly discussed.


Breast cancer Brain metastasis Biomarkers Hormonal therapy Chemotherapy Extracranial metastasis Surgical resection 


  1. 1.
    Yeh RH, Yu JC, Chu CH, Ho CL, Kao HW, Liao GS, Chen HW, Kao WY, Yu CP, Chao TY, Dai MS (2014) Distinct MR imaging features of triple-negative breast cancer with brain metastasis. J Neuroimag 25:474–481CrossRefGoogle Scholar
  2. 2.
    Lin NU (2013) Breast cancer brain metastases: new directions in systemic therapy. Ecancermedicalscience. 7:307PubMedPubMedCentralGoogle Scholar
  3. 3.
    Arslan UY, Oksuzoglu B, Aksoy S, Harputluoglu H, Turker I, Ozisik Y, Dizdar O, Altundag K, Alkis N, Zengin N (2011) Breast cancer subtypes and outcomes of central nervous system metastases. Breast 20:562–567CrossRefPubMedGoogle Scholar
  4. 4.
    Altundag K, Bondy ML, Mirza NQ, Kau SW, Broglio K, Hortobagyi GN, Rivera E (2007) Clinicopathologic characteristics and prognostic factors in 420 metastatic breastcancer patients with central nervous system metastasis. Cancer 110:2640–2647CrossRefPubMedGoogle Scholar
  5. 5.
    Rades D, Lohynska R, Veninga T, Stalpers LJ, Schild SE (2007) Evaluation of 2 whole-brain radiotherapy schedules and prognostic factors for brain metastases in breast cancer patients. Cancer 110:2587–2592CrossRefPubMedGoogle Scholar
  6. 6.
    Bir SC, Bollam P, Nanda A (2015) Outcomes and predictors of improved survival after gamma knife radiosurgery for metastatic brain tumors originated from breast carcinoma. Neurosurg Rev 38:489–498CrossRefPubMedGoogle Scholar
  7. 7.
    Chong JU, Ahn SG, Lee HM, Park JT, Lee SA, Park S, Jeong J (2015) Local control of brain metastasis: treatment outcome of focal brain treatments in relation to subtypes. J Breast Cancer 18:29–35CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Hayashi N, Niikura N, Masuda N, Takashima S, Nakamura R, Watanabe K, Kanbayashi C, Ishida M, Hozumi Y, Tsuneizumi M, Kondo N, Naito Y, Honda Y, Matsui A, Fujisawa T, Oshitanai R, Yasojima H, Yamauchi H, Saji S, Iwata H (2015) Prognostic factors of HER2-positive breast cancer patients who develop brain metastasis: a multicenter retrospective analysis. Breast Cancer Res Treat 149:277–284CrossRefPubMedGoogle Scholar
  9. 9.
    Leone JP, Lee AV, Brufsky AM (2015) Prognostic factors and survival of patients with brain metastasis from breast cancer who underwent craniotomy. Cancer Med 4:989–994CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Rades D, Huttenlocher S, Rudat V, Hornung D, Blanck O, Phuong PC, Khoa MT, Schild SE, Fischer D (2015) Radiosurgery with 20 Gy provides better local contol of 1–3 brain metastases from breast cancer than with lower doses. Anticancer Res 35:333–336PubMedGoogle Scholar
  11. 11.
    Shen Q, Sahin AA, Hess KR, Suki D, Aldape KD, Sawaya R, Ibrahim NK (2015) Breast cancer with brain metastases: clinicopathologic features, survival, and paired biomarker analysis. Oncologist 20:466–473CrossRefPubMedGoogle Scholar
  12. 12.
    Hung MH, Liu CY, Shiau CY, Hsu CY, Tsai YF, Wang YL, Tai LC, King KL, Chao TC, Chiu JH, Su CH, Lo SS, Tzeng CH, Shyr YM, Tseng LM (2014) Effect of age and biological subtype on the risk and timing of brain metastasis in breast cancer patients. Plos One 9:e89389CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Niikura N, Hayashi N, Masuda N, Takashima S, Nakamura R, Watanabe K, Kanbayashi C, Ishida M, Hozumi Y, Tsuneizumi M, Kondo N, Naito Y, Honda Y, Matsui A, Fujisawa T, Oshitanai R, Yasojima H, Tokuda Y, Saji S, Iwata H (2014) Treatment outcomes and prognostic factors for patients with brain metastases from breast cancer of each subtype: a multicenter retrospective analysis. Breast Cancer Res Treat 147:103–112CrossRefPubMedGoogle Scholar
  14. 14.
    Ren Z, Li Y, Hameed O, Siegal GP, Wei S (2014) Prognostic factors in patients with metastatic breast cancer at the time of diagnosis. Pathol Res Pract 210:301–306CrossRefPubMedGoogle Scholar
  15. 15.
    Tung N, Gaughan E, Hacker MR, Lee LJ, Alexander B, Poles E, Schnitt SJ, Garber JE (2014) Outcome of triple negative breast cancer: comparison of sporadic and BRCA1-associated cancers. Breast Cancer Res Treat 146:175–182CrossRefPubMedGoogle Scholar
  16. 16.
    Bachelot T, Romieu G, Campone M, Diéras V, Cropet C, Dalenc F, Jimenez M, Le Rhun E, Pierga JY, Gonçalves A, Leheurteur M, Domont J, Gutierrez M, Curé H, Ferrero JM, Labbe-Devilliers C (2013) Lapatinib plus capecitabine in patients with previously untreated brain metastases from HER2-positive metastatic breast cancer (LANDSCAPE): a single-group phase 2 study. Lancet Oncol 14:64–71CrossRefPubMedGoogle Scholar
  17. 17.
    de Azambuja E, Zardavas D, Lemort M, Rossari J, Moulin C, Buttice A, D’Hondt V, Lebrun F, Lalami Y, Cardoso F, Sotiriou C, Gil T, Devriendt D, Paesmans M, Piccart-Gebhart M, Awada A (2013) Phase I trial combining temozolomide plus lapatinib for the treatment of brain metastases in patients with HER2-positive metastatic breast cancer: the LAPTEM trial. Ann Oncol 24:2985–2989CrossRefPubMedGoogle Scholar
  18. 18.
    Lobbezoo DJ, van Kampen RJ, Voogd AC, Dercksen MW, van den Berkmortel F, Smilde TJ, van de Wouw AJ, Peters FP, van Riel JM, Peters NA, de Boer M, Borm GF, Tjan-Heijnen VC (2013) Prognosis of metastatic breast cancer subtypes: the hormone receptor/HER2-positive subtype is associated with the most favorable outcome. Breast Cancer Res Treat 141:507–514CrossRefPubMedGoogle Scholar
  19. 19.
    Zhang Q, Chen J, Yu X, Ma J, Cai G, Yang Z, Cao L, Chen X, Guo X, Chen J (2013) Systemic treatment after whole-brain radiotherapy may improve survival in RPA class II/III breast cancer patients with brain metastasis. J Neurooncol 114:181–189CrossRefPubMedGoogle Scholar
  20. 20.
    Dayan A, Koca D, Akman T, Oztop I, Ellidokuz H, Yilmaz U (2012) The factors that have an impact on the development of brain metastasis in the patients with breast cancer. J Cancer Res Ther 8:542–548CrossRefPubMedGoogle Scholar
  21. 21.
    Jaboin JJ, Ferraro DJ, DeWees TA, Rich KM, Chicoine MR, Dowling JL, Mansur DB, Drzymala RE, Simpson JR, Magnuson WJ, Patel AH, Zoberi I (2013) Survival following gamma knife radiosurgery for brain metastasis from breast cancer. Radiat Oncol 8:131–138CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Gerdan L, Segedin B, Nagy V, Khoa MT, Trang NT, Schild SE, Rades D (2013) The number of involved extracranial organs: a new predictor of survival in breast cancer patients with brain metastasis. Clin Neurol Neurosurg 115:2108–2110CrossRefPubMedGoogle Scholar
  23. 23.
    Kaplan MA, Isikdogan A, Koca D, Kucukoner M, Gumusay O, Yildiz R, Dayan A, Demir L, Geredeli C, Kocer M, Arslan UY, Inal A, Akman T, Coskun U, Sener N, Inanc M, Elkiran ET, Ozdemir NY, Durnalı AG, Suner A, Alici S, Tarhan MO, Boruban C, Oksuzoglu B, Urakci Z (2013) Clinical outcomes in patients who received lapatinib plus capecitabine combination therapy for HER2-positive breast cancer with brain metastasis and a comparison of survival with those who received trastuzumab-based therapy: a study by the anatolian society of medical oncology. Breast Cancer 21:677–683CrossRefPubMedGoogle Scholar
  24. 24.
    Tarhan MO, Demir L, Somali I, Yigit S, Erten C, Alacacioglu A, Ellidokuz H, Seseogullari O, Kucukzeybek Y, Can A, Dirican A, Bayoglu V, Akyol M (2013) The clinicopathological evaluation of the breast cancer patients with brain metastases: predictors of survival. Clin Exp Metastasis 30:201–213CrossRefPubMedGoogle Scholar
  25. 25.
    Jaboin JJ, Ferraro DJ, DeWees TA, Rich KM, Chicoine MR, Dowling JL, Mansur DB, Drzymala RE, Simpson JR, Magnuson WJ, Patel AH, Zoberi I (2013) Survival following gamma knife radiosurgery for brain metastasis from breast cancer. Radiat Oncol 8:131–138CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Tseng LM, Hsu NC, Chen SC, Lu YS, Lin CH, Chang DY, Li H, Lin YC, Chang HK, Chao TC, Ouyang F, Hou MF (2013) Distant metastasis in triple-negative breast cancer. Neoplasma 60:290–294CrossRefPubMedGoogle Scholar
  27. 27.
    Wu X, Luo B, Wei S, Luo Y, Feng Y, Xu J, Wei W (2013) Efficiency and prognosis of whole brain irradiation combined with precise radiotherapy on triple-negative breast cancer. J Cancer Res Ther Suppl: S169–172Google Scholar
  28. 28.
    Gori S, Montemurro F, Spazzapan S, Metro G, Foglietta J, Bisagni G, Ferzi A, Silva RR, Gamucci T, Clavarezza M, Stocchi L, Fabi A, Cognetti F, Torrisi E, Crivellari D (2012) Retreatment with trastuzumab-based therapy after disease progression following lapatinib in HER2-positive metastatic breast cancer. Ann Oncol 23:1436–1441CrossRefPubMedGoogle Scholar
  29. 29.
    Jung JM, Kim S, Joo J, Shin KH, Gwak HS, Lee SH (2012) Incidence and risk factors for leptomeningeal carcinomatosis in breast cancer patients with parenchymal brain metastases. J Korean Neurosurg Soc 52:193–199CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Jung SY, Rosenzweig M, Sereika SM, Linkov F, Brufsky A, Weissfeld JL (2012) Factors associated with mortality after breast cancer metastasis. Cancer Causes Control 23:103–112CrossRefPubMedGoogle Scholar
  31. 31.
    Niikura N, Liu J, Hayashi N, Mittendorf EA, Gong Y, Palla SL, Tokuda Y, Gonzalez-Angulo AM, Hortobagyi GN, Ueno NT (2012) Loss of human epidermal growth factor receptor 2 (HER2) expression in metastatic sites of HER2-overexpressing primary breast tumors. J Clin Oncol 30:593–599CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Jang G, Lee SS, Ahn JH, Jung KH, Lee H, Gong G, Kim HH, Ahn SD, Son BH, Ahn SH, Kim SB (2011) Clinical features and course of brain metastases in triple-negative breast cancer: comparison with human epidermal growth factor receptor 2-positive and other type at single institution in Korea. Breast Cancer Res Treat 128:171–177CrossRefPubMedGoogle Scholar
  33. 33.
    Dawood S, Ueno NT, Valero V, Andreopoulou E, Hsu L, Lara J, Woodward W, Buchholz TA, Hortobagyi GN, Cristofanilli M (2010) Incidence of and survival following brain metastases among women with inflammatory breast cancer. Ann Oncol 21:2348–2355CrossRefPubMedGoogle Scholar
  34. 34.
    Graesslin O, Abdulkarim BS, Coutant C, Huguet F, Gabos Z, Hsu L, Marpeau O, Uzan S, Pusztai L, Strom EA, Hortobagyi GN, Rouzier R, Ibrahim NK (2010) Nomogram to predict subsequent brain metastasis in patients with metastatic breast cancer. J Clin Oncol 28:2032–2037CrossRefPubMedGoogle Scholar
  35. 35.
    Lin NU, Diéras V, Paul D, Lossignol D, Christodoulou C, Stemmler HJ, Roché H, Liu MC, Greil R, Ciruelos E, Loibl S, Gori S, Wardley A, Yardley D, Brufsky A, Blum JL, Rubin SD, Dharan B, Steplewski K, Zembryki D, Oliva C, Roychowdhury D, Paoletti P, Winer EP (2009) Multicenter phase II study of lapatinib in patients with brain metastases from HER2-positive breast cancer. Clin Cancer Res 15:1452–1459CrossRefPubMedGoogle Scholar
  36. 36.
    Bartsch R, Rottenfusser A, Wenzel C, Dieckmann K, Pluschnig U, Altorjai G, Rudas M, Mader RM, Poetter R, Zielinski CC, Steger GG (2007) Trastuzumab prolongs overall survival in patients with brain metastases from Her2 positive breast cancer. J Neurooncol 85:311–317CrossRefPubMedGoogle Scholar
  37. 37.
    Ekenel M, Hormigo AM, Peak S, Deangelis LM, Abrey LE (2007) Capecitabine therapy of central nervous system metastases from breast cancer. J Neurooncol 85:223–227CrossRefPubMedGoogle Scholar
  38. 38.
    Niwińska A, Tacikowska M, Pieńkowski T (2007) Occult brain metastases in HER2- positive breast cancer patients: frequency and response to radiotherapy. Acta Oncol 46:1027–1029CrossRefPubMedGoogle Scholar
  39. 39.
    Ogawa K, Yoshii Y, Nishimaki T, Tamaki N, Miyaguni T, Tsuchida Y, Kamada Y, Toita T, Kakinohana Y, Tamaki W, Iraha S, Adachi G, Hyodo A, Murayama S (2008) Treatment and prognosis of brain metastases from breast cancer. J Neurooncol 86:231–238CrossRefPubMedGoogle Scholar
  40. 40.
    Boogerd W, Hart AA, Tjahja IS (1997) Treatment and outcome of brain metastasis as first site of distant metastasis from breast cancer. J Neurooncol 35:161–167CrossRefPubMedGoogle Scholar
  41. 41.
    Wroński M, Arbit E, McCormick B (1997) Surgical treatment of 70 patients with brain metastases from breast carcinoma. Cancer 80:1746–1754CrossRefPubMedGoogle Scholar
  42. 42.
    Boogerd W, Vos VW, Hart AA, Baris G (1993) Brain metastases in breast cancer; natural history, prognostic factors and outcome. J Neurooncol 15:165–174CrossRefPubMedGoogle Scholar
  43. 43.
    Patanaphan V, Salazar OM, Risco R (1988) Breast cancer: metastatic patterns and their prognosis. South Med J 81:1109–1112CrossRefPubMedGoogle Scholar
  44. 44.
    DiStefano A, Yong Yap Y, Hortobagyi GN, Blumenschein GR (1979) The natural history of breast cancer patients with brain metastases. Cancer 44:1913–1918CrossRefPubMedGoogle Scholar
  45. 45.
    Lin NU, Bellon JR, Winer EP (2004) CNS metastases in breast cancer. J Clin Oncol 22:3608–3617CrossRefPubMedGoogle Scholar
  46. 46.
    Rudat V, El-Sweilmeen H, Brune-Erber I, Nour AA, Almasri N, Altuwaijri S, Fadel E (2014) Identification of breast cancer patients with a high risk of developing brain metastases: a single-institutional retrospective analysis. BMC Cancer 14:289CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Graf AH, Buchberger W, Langmayr H, Schmid KW (1988) Site preference of metastatic tumours of the brain. Virchows Arch A Pathol Anat Histopathol 412:493–498CrossRefPubMedGoogle Scholar
  48. 48.
    Pakneshan S, Safarpour D, Tavassoli F, Jabbari B (2014) Brain metastasis from ovarian cancer: a systematic review. J Neurooncol 119:1–6CrossRefPubMedGoogle Scholar
  49. 49.
    Gorovets D, Rava P, Ebner DK, Tybor DJ, Cielo D, Puthawala Y (2015) Predictors for long-term survival free from whole brain radiation therapy in patients treated with radiosurgery for limited brain metastases. Front Oncol 5:110–115CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Prat A, Perou CM (2011) Deconstructing the molecular portraits of breast cancer. Mol Oncol 5:5–23CrossRefPubMedGoogle Scholar
  51. 51.
    Soni A, Ren Z, Hameed O, Chanda D, Morgan CJ, Siegal GP, Wei S (2015) Breast cancer subtypes predispose the site of distant metastases. Am J Clin Pathol 143:471–478CrossRefPubMedGoogle Scholar
  52. 52.
    Olson EM, Abdel-Rasoul M, Maly J, Wu CS, Lin NU, Shapiro CL (2013) Incidence and risk of central nervous system metastases as site of first recurrence in patients with HER2 positive breast cancer treated with adjuvant trastuzumab. Ann Oncol 24:1526–1533CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Duchnowska R, Sperinde J, Chenna A, Huang W, Weidler JM, Winslow J, Haddad M, Paquet A, Lie Y, Trojanowski T, Mandat T Kowalczyk A, Czartoryska-Arłukowicz B, Radecka B, Jarosz B, Staszkiewicz R, Kalinka-Warzocha E, Chudzik M, Biernat W, Jassem J (2015) Quantitative HER2 and p95HER2 levels in primary breast cancers and matched brain metastases. Neuro OncolGoogle Scholar
  54. 54.
    Swain SM, Im YH, Im SA, Chan V, Miles D, Knott A, Clark E, Ross G, Baselga J (2014) Safety profile of Pertuzumab with Trastuzumab and Docetaxel in patients from Asia with human epidermal growth factor receptor 2-positive metastatic breast cancer: results from the phase III trial CLEOPATRA. Oncologist 19:693–701CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Bartsch R, De Vries C, Pluschnig U, Dubsky P, Bago-Horvath Z, Gampenrieder SP, Rudas M, Mader RM, Rottenfusser A, Wiltschke C, Gnant M, Zielinski CC, Steger GG (2009) Predicting for activity of second-line trastuzumab-based therapy in her2-positive advanced breast cancer. BMC Cancer 9:367–376CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Kodack DP, Askoxylakis V, Ferraro GB, Fukumura D, Jain RK (2015) Emerging strategies for treating brain metastases from breast cancer. Cancer Cell 27:163–175CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Yamamoto D, Iwase S, Tsubota Y, Sueoka N, Yamamoto C, Kitamura K, Odagiri H, Nagumo Y (2012) Bevacizumab in the treatment of five patients with breast cancer and brain metastases: Japan breast cancer research network-07 trial. Onco Targets Ther 5:185–189CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Rodriguez PL, Jiang S, Fu Y, Avraham S, Avraham HK (2014) The proinflammatory peptide substance P promotes blood-brain barrier breaching by breast cancer cells through changes in microvascular endothelial cell tight junctions. Int J Cancer 134:1034–1044CrossRefPubMedGoogle Scholar
  59. 59.
    Bos PD, Zhang XH, Nadal C, Shu W, Gomis RR, Nguyen DX, Minn AJ, van de Vijver MJ, Gerald WL, Foekens JA, Massagué J (2009) Genes that mediate breast cancer metastasis to the brain. Nature 459:1005–1009CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Yonemori K, Tsuta K, Ono M, Shimizu C, Hirakawa A, Hasegawa T, Hatanaka Y, Narita Y, Shibui S, Fujiwara Y (2010) Disruption of the blood brain barrier by brain metastases of triple-negative and basal-type breast cancer but not HER2/neu-positive breast cancer. Cancer 116:302–308CrossRefPubMedGoogle Scholar
  61. 61.
    Pangeni RP, Channathodiyil P, Huen DS, Eagles LW, Johal BK, Pasha D, Hadjistephanou N, Nevell O, Davies CL, Adewumi AI, Khanom H, Samra IS, Buzatto VC, Chandrasekaran P, Shinawi T, Dawson TP, Ashton KM, Davis C, Brodbelt AR, Jenkinson MD, Bièche I, Latif F, Darling JL, Warr TJ, Morris MR (2015) The GALNT9, BNC1 and CCDC8 genes are frequently epigenetically dysregulated in breast tumours that metastasise to the brain. Clin Epigenetics 7:57–73CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Harrell JC, Prat A, Parker JS, Fan C, He X, Carey L, Anders C, Ewend M, Perou CM (2012) Genomic analysis identifies unique signatures predictive of brain, lung, and liver relapse. Breast Cancer Res Treat 132:523–535CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Fitzgerald DP, Palmieri D, Hua E, Hargrave E, Herring JM, Qian Y, Vega-Valle E, Weil RJ, Stark AM, Vortmeyer AO, Steeg PS (2008) Reactive glia are recruited by highly proliferative brain metastases of breast cancer and promote tumor cell colonization. Clin Exp Metastasis 25:799–810CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of NeurologyYale University School of MedicineNew HavenUSA
  2. 2.Department of NeurologyCase Western Reserve University School of MedicineClevelandUSA
  3. 3.School of MedicineSt. George UniversitySt. George’sGrenada, West Indies
  4. 4.Department of PathologyYale University School of MedicineNew HavenUSA

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