Skip to main content

Management of isolated leptomeningeal metastasis as the initial and sole site of recurrence in a patient with early-stage breast cancer


In breast cancer, leptomeningeal metastasis is increasingly seen in patients with hormone receptor and HER-2-positive disease as the newer therapies used have limited CNS penetration. Leptomeningeal disease is an end-stage presentation usually occurring in tandem with systemic metastases, limiting a patient’s overall survival to 6 months. We present a case with isolated leptomeningeal metastasis as the initial and sole site of recurrence in a patient with early-stage, luminal-type breast cancer. Despite the early stage at diagnosis, this patient recurred within three years likely due to high nodal burden at initial presentation. In the setting of leptomeningeal metastases without intraparenchymal or extracranial disease and good performance status, a patient’s overall survival can be extended longer than the average time span with the use of multiple intrathecal and systemic chemotherapies.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. Kesari S, Batchelor TT (2003) Leptomeningeal metastases. Neurol Clin 21:25–26

    Article  PubMed  Google Scholar 

  2. Gauthier H, Guilhaume MN, Bidard FC et al (2010) Survival of breast cancer patients with meningeal carcinomatosis. Ann Oncol 21:2183–2187

    Article  CAS  PubMed  Google Scholar 

  3. Hicks DG, Short SM, Prescott NL et al (2006) 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 30:1097–1104

    Article  PubMed  Google Scholar 

  4. Yust-Katz S, Garciaren P, Liu D, Yuan Y et al (2013) Breast cancer and leptomeningeal disease (LMD): hormone receptor status influences time to development of LMD and survival from LMD diagnosis. J Neurooncol 114(2):229–235

    Article  CAS  PubMed  Google Scholar 

  5. Jayson G, Howell A (1996) Carcinomatous meningitis in solid tumors. Ann Oncol 7:773–786

    Article  CAS  PubMed  Google Scholar 

  6. Groves M (2010) New strategies in the management of leptomeningeal metastases. Arch Neurol 67(3):305–312

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  8. Clatot F, Philippin-Lauridant G, Ouvrier MJ et al (2009) Clinical improvement and survival in breast cancer leptomeningeal metastasis correlate with the cytologic response to intrathecal chemotherapy. J Neurooncol 95(3):421–426

    Article  CAS  PubMed  Google Scholar 

  9. De Azevedo CR, Cruz MR, Chinen LT et al (2011) Meningeal carcinomatosis in breast cancer: prognostic factors and outcome. J Neurooncol 104(2):565–572

    Article  PubMed  Google Scholar 

  10. Jo J-C, Kang MJ, Kim JE et al (2013) Clinical features and outcome of leptomeningeal metastasis in patients with breast cancer: a single center experience. Cancer Chemother Pharmacol 72:201–207

    Article  CAS  PubMed  Google Scholar 

Download references


The authors are grateful to Kamille West MD, Mount Sinai Beth Israel.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Isabel Ruth Preeshagul.

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kakani, C., Preeshagul, I.R., Fisher, R. et al. Management of isolated leptomeningeal metastasis as the initial and sole site of recurrence in a patient with early-stage breast cancer. Int Canc Conf J 4, 101–104 (2015).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Leptomeningeal
  • Breast cancer
  • Recurrence
  • Metastasis