Skip to main content
SpringerLink
Log in

Breast Cancer Metastasis to the Central Nervous System

  • Chapter
  • First Online:
Tumors of the Central Nervous System, Volume 4

Part of the book series: Tumors of the Central Nervous System ((TCNS,volume 4))

  • 1715 Accesses

Abstract

As breast cancer patients live longer, the development of central nervous system (CNS) metastases has become more prevalent. Clinically symptomatic breast cancer metastasis to the CNS is associated with significant morbidity and mortality. The blood-brain barrier (BBB) and the unique microenvironment and pathophysiology of the CNS create treatment challenges in this unique population. New therapeutic approaches are advancing the limits of the management of metastatic breast cancer to the CNS. Enhancements in surgical techniques and in targeted radiation are allowing better control of CNS metastases, while chemotherapy and targeted agents continue to play a major role in the treatment and research efforts. In addition to brain metastases, leptomeningeal carcinomatosis, spinal metastases and ocular metastases present particular challenges to clinicians and researchers. Future research efforts aimed at breast cancer patients with CNS metastases may focus on identifying patients at greater risk, enhancing treatment options, and identifying new diagnostic and predictive markers.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abrey LE, Olson JD, Raizer JJ, Mack M, Rodavitch A, Boutros DY, Malkin MG (2001) A phase II trial of temozolomide for patients with recurrent or progressive brain metastases. J Neurooncol 53(3):259–265

    Article  PubMed  CAS  Google Scholar 

  • Addeo R, De Rosa C, Faiola V, Leo L, Cennamo G, Montella L, Guarrasi R, Vincenzi B, Caraglia M, Del Prete S (2008). Phase 2 trial of temozolomide using protracted low-dose and whole-brain radiotherapy for nonsmall cell lung cancer and breast-cancer patients with brain metastases. Cancer 113(9):2524–2531

    Article  PubMed  CAS  Google Scholar 

  • 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 110:2640–2647

    Article  PubMed  CAS  Google Scholar 

  • Andrews DW, Scott CB, Sperduto DW, Flanders AE, Gaspar LE, Schell MC, Werner-Wasik M, Demas W, Ryu J, Bahary JP, Souhami L, Rotman M, Mehta MP, Curran WJ Jr. (2004, May 22) Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with the top three brain metastases: phase III results of the RTOG 9503 randomized trial. Lancet 363(9422):1665–1672

    Article  PubMed  Google Scholar 

  • Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, Kenjyo M, Oya N, Hirota S, Shioura H, Kunieda E, Inomata T, Hayakawa K, Katoh N, Kobashi G (2006) Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 7:295(21):2483–2491

    CAS  Google Scholar 

  • Arslan C, Dizdar O, Altundag K (2010) Systemic treatment in breast-cancer patients with brain metastasis. Expert Opin Pharmacother 11(7):1089–1100

    Article  PubMed  CAS  Google Scholar 

  • Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE (2004) Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol 22(14):2865–2872

    Article  PubMed  Google Scholar 

  • Bindal AK, Bindal RK, Hess KR, Shiu A, Hassenbusch SJ, Shi WM, Sawaya R (1996) Surgery versus radiosurgery in the treatment of brain metastasis. J Neurosurg 84(5):748–754

    Article  PubMed  CAS  Google Scholar 

  • Christodoulou C, Bafaloukos D, Kosmidis P, Samantas E, Bamias A, Papakostas P, Karabelis A, Bacoyiannis C, Skarlos DV (2001) Phase II study of temozolomide in heavily pretreated cancer patients with brain metastases. Ann Oncol 2(2):249–254

    Article  Google Scholar 

  • Christodoulou C, Bafaloukos D, Linardou H, Aravantinos G, Bamias A, Carina M, Klouvas G, Skarlos D (2005). Temozolomide (TMZ) combined with cisplatin (CDDP) in patients with brain metastases from solid tumors: a Hellenic Cooperative Oncology Group (HeCOG) Phase II study. J Neurooncol 71(1):61–65

    Article  PubMed  CAS  Google Scholar 

  • Cocconi G, Lottici R, Bisagni G, Bacchi M, Tonato M, Passalacqua R, Boni C, Belsanti V, Bassi P (1990) Combination therapy with platinum and etoposide of brain metastases from breast carcinoma. Cancer Invest 8(3–4):327–334

    Article  PubMed  CAS  Google Scholar 

  • Cole BF, Glantz MJ, Jaeckle KA, Chamberlain MC, Mackowiak JI (2003) Quality-of-life-adjusted survival comparison of sustained-release cytosine arabinoside versus intrathecal methotrexate for treatment of solid tumor neoplastic meningitis. Cancer 97(12):3053–3060

    Article  PubMed  CAS  Google Scholar 

  • Collie DA, Brush JP, Lammie GA (1999) Imaging features of leptomeningeal metastases. Clin Radiol 54(11):765–771

    Article  PubMed  CAS  Google Scholar 

  • Curry WT Jr, Cosgrove GR, Hochberg FH, Loeffler J, Zervas NT (2005) Stereotactic interstitial radiosurgery for cerebral metastases. J Neurosurg 103(4):630–635

    Article  PubMed  Google Scholar 

  • Dawood S, Broglio K, Esteva FJ, Yang W, Kau SW, Islam R, Albarracin C, Yu TK, Green M, Hortobagyi GN, Gonzalez-Angulo AM (2009) Survival among women with triple receptor-negative breast cancer and brain metastases. Ann Oncol 20(4):621–627

    Article  PubMed  CAS  Google Scholar 

  • Ekenel M, Hormigo AM, Peak S, Deangelis LM, Abrey LE (2007) Capecitabine therapy of central nervous system metastases from breast cancer. J Neurooncol 85(2):223–227

    Article  PubMed  CAS  Google Scholar 

  • Evans AJ, James JJ, Cornford EJ, Chan SY, Burrell HC, Pinder SE, Gutteridge E, Robertson JF, Hornbuckle J, Cheung KL (2004) Brain metastases from breast cancer: identification of a high-risk group. Clin Oncol (R Coll Radiol) 16(5):345–349

    CAS  Google Scholar 

  • Franciosi V, Cocconi G, Michiara M, Di Costanzo F, Fosser V, Tonato M, Carlini P, Boni C, Di Sarra S (1999) Front-line chemotherapy with cisplatin and etoposide for patients with brain metastases from breast carcinoma, nonsmall cell lung carcinoma, or malignant melanoma: a prospective study. Cancer 85(7):1599–1605

    Article  PubMed  CAS  Google Scholar 

  • Friedman HS (2003) Phase II trial of temozolomide for patients with progressive brain metastases. 2003 ASCO Annual Meeting (Central Nervous System Session, Poster Discussion)

    Google Scholar 

  • 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. JCO 28:2032–2037

    Article  Google Scholar 

  • Hedde JP, Neuhaus T, Schüller H, Metzler U, Schmidt-Wolf IG, Kleinschmidt R, Losem C, Lange O, Grohe C, Stier S, Ko YD (2007) A phase I/II trial of topotecan and radiation therapy for brain metastases in patients with solid tumors. Int J Radiat Oncol Biol Phys 68(3):839–844

    Article  PubMed  CAS  Google Scholar 

  • Kocher M, Eich HT, Semrau R, Güner SA, Müller RP (2005) Phase I/II trial of simultaneous whole-brain irradiation and dose-escalating topotecan for brain metastases. Strahlenther Onkol 181(1):20–25

    Article  PubMed  Google Scholar 

  • Lee SS, Kim MK, Sym SJ, Kim SW, Kim WK, Kim SB, Ahn JH (2007) Intramedullary spinal cord metastases: a single-institution experience. J Neurooncol 84(1):85–89

    Article  PubMed  Google Scholar 

  • Lin NU, Bellon JR, Winer EP (2008) CNS metastases in breast cancer. J Clin Oncol 22(17):3608–3617

    Article  Google Scholar 

  • Lin NU, Claus E, Sohl J, Razzak AR, Arnaout A, Winer EP (2008) Sites of distant recurrence and clinical outcomes in patients with metastatic triple-negative breast cancer: high incidence of central nervous system metastases. Cancer 113(10):2638–2645

    Article  PubMed  Google Scholar 

  • 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(4):1452–1459

    Article  PubMed  CAS  Google Scholar 

  • Loeffler JS, Kooy HM, Wen PY Fine HA, Cheng CW, Mannarino EG, Tsai JS, Alexander E 3rd (1990) The treatment of recurrent brain metastases with stereotactic radiosurgery. J Clin Oncol 8(4):576–582

    PubMed  CAS  Google Scholar 

  • Maor M, Chan RC, Young SE (1977) Radiotherapy of choroidal metastases: breast cancer as primary site. Cancer 40(5):2081–2086

    Article  PubMed  CAS  Google Scholar 

  • Melisko ME, Anderson M, Scott J et al. (2009) Phase II study of irinotecan and temozolomide in breast-cancer patients with brain metastases or leptomeningeal disease that has progressed after stereotactic radiosurgery or whole brain radiation. 2009 ASCO Breast Cancer Symposium, Abstract No. 237

    Google Scholar 

  • Melisko ME, Moore DH, Sneed PK, De Franco J, Rugo HS (2008) Brain metastases in breast cancer: clinical and pathologic characteristics associated with improvements in survival. J Neurooncol 88(3):359–365

    Article  PubMed  Google Scholar 

  • Nam BH, Kim SY, Han HS, Kwon Y, Lee KS, Kim TH, Ro J (2008) Breast cancer subtypes and survival in patients with brain metastases. Breast Cancer Res 10(1):R20

    Article  PubMed  Google Scholar 

  • Naskhletashvili DR, Gorbounova VA, Bychkov MB, et al. (2009) Capecitabine monotherapy for patients with brain metastases from advanced breast cancer. 2009 ASCO Annual Meeting, Abstract No. 1102

    Google Scholar 

  • Oberhoff C, Kieback DG, Wurstlein R, Deertz H, Sehouli J, van Soest C, Hilfrich J, Mesrogli M, von Minckwitz G, Staab HJ, Schindler AE (2001) Topotecan chemotherapy in patients with breast cancer and brain metastases: results of a pilot study. Onkologie 24(3):256–260

    Article  PubMed  CAS  Google Scholar 

  • Patchell RA, Tibbs PA, Regine WF, Dempsey RJ, Mohiuddin M, Kryscio RJ, Markesbery WR, Foon KA, Young B (1998) Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 280(17):1485–1489

    Article  PubMed  CAS  Google Scholar 

  • Pestalozzi BC, Francis P, Quinaux E, Dempsey RJ, Mohiuddin M, Kryscio RJ, Markesbery WR, Foon KA, Young B (2008) Is risk of central nervous system (CNS) relapse related to adjuvant taxane treatment in node-positive breast cancer? Results of the CNS substudy in the intergroup Phase III BIG 02-98 Trial. Ann Oncol 19(11):1837–1841

    Article  PubMed  CAS  Google Scholar 

  • Rivera E, Meyers C, Groves M, Valero V, Francis D, Arun B, Broglio K, Yin G, Hortobagyi GN, Buchholz T (2006). Phase I study of capecitabine in combination with temozolomide in the treatment of patients with brain metastases from breast carcinoma. Cancer 107(6):1348–1354

    Article  PubMed  CAS  Google Scholar 

  • Rogers LR, Rock JP, Sills AK, Vogelbaum MA, Suh JH, Ellis TL, Stieber VW, Asher AL, Fraser RW, Billingsley JS, Lewis P, Schellingerhout D, Shaw EG (2006) Results of a phase II trial of the GliaSite radiation therapy system for the treatment of newly diagnosed, resected single brain metastases. J Neurosurg 105(3):375–384

    Article  PubMed  Google Scholar 

  • Rosner D, Nemoto T, Lane WW (1986) Chemotherapy induces regression of brain metastases in breast carcinoma. Cancer 58(4):832–839

    Article  PubMed  CAS  Google Scholar 

  • Salvati M, Cervoni L, Innocenzi G, Bardella L (1993) Prolonged stabilization of multiple and single brain metastases from breast cancer with tamoxifen. Report of three cases. Tumori79(5):359–362

    PubMed  CAS  Google Scholar 

  • Sawaya R, Hammoud M, Schoppa D, Hess KR, Wu SZ, Shi WM, Wildrick DM (1998) Neurosurgical outcomes in a modern series of 400 craniotomies for treatment of parenchymal tumors. Neurosurgery 42(5):1044–1055

    Article  PubMed  CAS  Google Scholar 

  • Schiff D, DeAngelis LM (1994) Therapy of venous thromboembolism in patients with brain metastases. Cancer 73(2):493–498

    Article  PubMed  CAS  Google Scholar 

  • Schouten LJ, Rutten J, Huveneers HA, Twijnstra A (2002) Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma. Cancer 94:2698–2705

    Article  PubMed  Google Scholar 

  • Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J, Farnan N (2000) Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys 47(2):291–298

    Article  PubMed  CAS  Google Scholar 

  • Soffietti R, Rudā R, Mutani RJ (2002) Management of brain metastases. Neurology 249(10):1357–1369

    Article  Google Scholar 

  • Stewart DJ, Mikhael NZ, Nair RC, Kacew S, Montpetit V, Nanji A, Maroun JA, Howard K (1988) Platinum concentrations in human autopsy tumor samples. Am J Clin Oncol 11(2):152–158

    Article  PubMed  CAS  Google Scholar 

  • Suh JH, Stea B, Nabid A, Kresl JJ, Fortin A, Mercier JP, Senzer N, Chang EL, Boyd AP, Cagnoni PJ, Shaw E (2006) Phase III study of efaproxiral as an adjunct to whole-brain radiation therapy for brain metastases. J Clin Oncol 24(1):106–114

    Article  PubMed  CAS  Google Scholar 

  • Suh J, Stea B, Tankel K, Marsiglia H, Belkacemi Y, Gomez H, et al. (2007). Phase 3 enrich (RT-016) comparative study of efaproxiral administered concurrent with whole brain radiation therapy (WBRT) in women with brain metastases from breast cancer. RT-35. Society for Neurooncology 12th Annual Meeting, Dallas, Texas

    Google Scholar 

  • Tosoni A, Franceschi E, Ermani M, Bertorelle R, Bonaldi L, Blatt V, Brandes AA (2008) Temozolomide three weeks on and one week off as first line therapy for patients with recurrent or progressive low grade gliomas. J Neurooncol 89(2):179–185

    Article  PubMed  CAS  Google Scholar 

  • Trudeau ME, Crump M, Charpentier D, Yelle L, Bordeleau L, Matthews S, Eisenhauer E (2006) Temozolomide in metastatic breast cancer (MBC): a phase II trial of the National Cancer Institute of Canada – Clinical Trials Group (NCIC-CTG). Ann Oncol 17(6):952–956

    Article  PubMed  CAS  Google Scholar 

  • Tsukada Y, Fouad A, Pickren JW, Lane WW (1983) Central nervous system metastasis from breast carcinoma. Autopsy study. Cancer 52(12):2349–2354

    Article  PubMed  CAS  Google Scholar 

  • Wong WW, Schild SE, Sawyer TE, Shaw EG (1996) Analysis of outcome in patients reirradiated for brain metastases. Int J Radiat Oncol Biol Phys 34(3):585–590

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA

    Marc R. Matrana & Nuhad K. Ibrahim

Authors
  1. Marc R. Matrana
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nuhad K. Ibrahim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nuhad K. Ibrahim .

Editor information

Editors and Affiliations

  1. , Kean University, Room 213, Library building, Morris Avenue 1000, Union, 07083, New Jersey, USA

    M.A. Hayat

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media B.V.

About this chapter

Cite this chapter

Matrana, M.R., Ibrahim, N.K. (2012). Breast Cancer Metastasis to the Central Nervous System. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 4. Tumors of the Central Nervous System, vol 4. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1706-0_4

Download citation

  • DOI: https://doi.org/10.1007/978-94-007-1706-0_4

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-1705-3

  • Online ISBN: 978-94-007-1706-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation