Assessment of the management of carcinomatous meningitis from breast cancer globally: a study by the Breast International Group Brain Metastasis Task Force

Razis, E. et al. (2022) Assessment of the management of carcinomatous meningitis from breast cancer globally: a study by the Breast International Group Brain Metastasis Task Force. ESMO Open, 7(3), 100483. (doi: 10.1016/j.esmoop.2022.100483) (PMID:35576695) (PMCID:PMC9291630)

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Background: Carcinomatous meningitis (CM) is a severe complication of breast cancer. The Breast International Group (BIG) carried out a survey to describe the approach to CM internationally. Patients and methods: A questionnaire on the management of CM was developed by the Brain Metastases Task Force of BIG and distributed to its groups, requesting one answer per group site. Results: A total of 241 sites responded, 119 from Europe, 9 from North America, 39 from Central/South America, 58 from Asia, and 16 in Australia/New Zealand, with 24.5% being general hospitals with oncology units, 44.4% university hospitals, 22.4% oncology centers, and 8.7% private hospitals. About 56.0% of sites reported seeing <5 cases annually with 60.6% reporting no increase in the number of cases of CM recently. Nearly 63.1% of sites investigate for CM when a patient has symptoms or radiological evidence, while 33.2% investigate only for symptoms. For diagnosis, 71.8% of sites required a positive cerebrospinal fluid cytology, while magnetic resonance imaging findings were sufficient in 23.7% of sites. Roughly 97.1% of sites treat CM and 51.9% also refer patients to palliative care. Intrathecal therapy is used in 41.9% of sites, mainly with methotrexate (74.3%). As many as 20 centers have a national registry for patients with breast cancer with central nervous system metastases and of those 5 have one for CM. Most (90.9%) centers would be interested in participating in a registry as well as in studies for CM, the latter preferably (62.1%) breast cancer subtype specific. Conclusions: This is the first study to map out the approach to CM from breast cancer globally. Although guidelines with level 1 evidence are lacking, there is a high degree of homogeneity in the approach to CM globally and great interest for conducting studies in this area.

Item Type:Articles
Glasgow Author(s) Enlighten ID:MacPherson, Professor Iain
Authors: Razis, E., Escudero, M.J., Palmieri, C., Mueller, V., Bartsch, R., Rossi, G., Gampenrieder, S.P., Kolberg, H.C., Zdenkowski, N., Pavic, M., Connolly, R.M., Rosset, L., Arcuri, J., Tesch, H., Vallejos, C., Retamales, J., Musolino, A., Del Mastro, L., Christodoulou, C., Aebi, S., Paluch-Shimon, S., Gupta, S., Ohno, S., MacPherson, I., Ekholm, M., Zaman, K., Vidal, M., Chakiba, C., Fumagalli, D., Thulin, A., Witzel, I., Kotecki, N., Gil-Gil, M., and Linderholm, B.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
Journal Name:ESMO Open
ISSN (Online):2059-7029
Published Online:13 May 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in ESMO Open 7(3):100483
Publisher Policy:Reproduced under a Creative Commons licence

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