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    Carcinomatous meningitis in patients with breast cancer. An aggressive disease variant.

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    Authors
    Jayson, Gordon C
    Howell, Anthony
    Harris, Martin
    Morgenstern, Godfrey R
    Chang, James
    Ryder, W David J
    Affiliation
    Department of Medical Oncology, Christie Hospital National Health Service Trust, Withington, Manchester, United Kingdom.
    Issue Date
    1994-12-15
    
    Metadata
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    Abstract
    BACKGROUND: Carcinomatous meningitis is a rare and often devastating complication in patients with breast cancer, and the treatment is controversial. METHODS: A retrospective analysis of 35 patients with carcinomatous meningitis from breast cancer was performed to define the biology of the disease and to guide treatment. RESULTS: An aggressive variant of breast cancer was revealed: meningeal metastasis complicates less than 3.5% of cases of metastatic breast carcinoma. Sixty-seven percent of these patients had tumors that were lobular or combined lobular/ductal histology; the median intervals from primary treatment to disease recurrence and from recurrence to death were 10.9 and 15 months, respectively. The median survival after diagnosis of carcinomatous meningitis was 77 days. The most significant prognostic factor was the Karnofsky performance status (KP) at presentation of meningeal disease. Patients with a KP greater or equal to 70 survived a median of 313 days, whereas those with a KP of 60 or less survived for a median of 36 days (P = 0.0002). In addition, there was a trend suggesting that the response 2 weeks after treatment was initiated, correlated with survival. CONCLUSIONS: Carcinomatous meningitis from breast carcinoma is an aggressive metastatic complication with a poor prognosis. The authors suggest that patients with a poor KP (< 70) should be treated symptomatically and those with a good KP (> or = 70) should receive more aggressive treatment. The patients' survival in this study compared well with other reports, and yet, only one patient was treated with intraventricular chemotherapy. Therefore, these data question the superiority of intraventricular treatment versus other modalities.
    Citation
    Carcinomatous meningitis in patients with breast cancer. An aggressive disease variant. 1994, 74 (12):3135-41 Cancer
    Journal
    Cancer
    URI
    http://hdl.handle.net/10541/97029
    DOI
    10.1002/1097-0142(19941215)74:12<3135::AID-CNCR2820741212>3.0.CO;2-8
    PubMed ID
    7982179
    Type
    Article
    Language
    en
    ISSN
    0008-543X
    ae974a485f413a2113503eed53cd6c53
    10.1002/1097-0142(19941215)74:12<3135::AID-CNCR2820741212>3.0.CO;2-8
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