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Molecular and Genetic Predictors of Breast-to-Brain Metastasis: Review and Case Presentation.

Medress Z, Hayden Gephart M - Cureus (2015)

Bottom Line: Brain metastases are the most common intracranial malignancy, and breast cancer is the second most common cancer to metastasize to the brain.Intracranial disease is a late manifestation of breast cancer with few effective treatment options, affecting 15-50% of breast cancer patients, depending upon molecular subtype.We believe that advances in the understanding of breast to brain metastasis pathogenesis will lead to targeted molecular therapies and to improvements in the ability to prospectively identify patients at increased risk for developing intracranial disease.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Stanford University.

ABSTRACT
Brain metastases are the most common intracranial malignancy, and breast cancer is the second most common cancer to metastasize to the brain. Intracranial disease is a late manifestation of breast cancer with few effective treatment options, affecting 15-50% of breast cancer patients, depending upon molecular subtype. In this review article, we describe the genetic, molecular, and metabolic changes in breast cancer cells that facilitate breast to brain metastasis. We believe that advances in the understanding of breast to brain metastasis pathogenesis will lead to targeted molecular therapies and to improvements in the ability to prospectively identify patients at increased risk for developing intracranial disease.

No MeSH data available.


Related in: MedlinePlus

Resection of Dural-based Brain MetastasisPre- and postoperative MRI images demonstrate resection of a breast cancer dural-based metastasis. Preoperative axial T2 (A) and T1 with contrast images (B) show a heterogeneously enhancing 2.9 x 5.9 x 2.9 cm dural-based tumor in the right temporal-parietal region associated with significant peri-tumoral edema and midline shift. Postoperative T2 (C) and T1 with contrast images (D) demonstrate tumor resection.
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FIG1: Resection of Dural-based Brain MetastasisPre- and postoperative MRI images demonstrate resection of a breast cancer dural-based metastasis. Preoperative axial T2 (A) and T1 with contrast images (B) show a heterogeneously enhancing 2.9 x 5.9 x 2.9 cm dural-based tumor in the right temporal-parietal region associated with significant peri-tumoral edema and midline shift. Postoperative T2 (C) and T1 with contrast images (D) demonstrate tumor resection.

Mentions: A 59-year-old woman with a five-year history of invasive ductal ER, PR, and HER2/neu-positive breast cancer presented with a history of headache, nausea, and decreased oral intake. The patient had undergone a mastectomy, followed by neoadjuvant chemotherapy (doxorubicin, cyclophosphamide, paclitaxel, trastuzumab, paclitaxel), and radiation. On initial examination, she had decreased orientation and level of consciousness, hemineglect, and left-sided pronator drift. A head CT demonstrated a large right-sided temporal-parietal mass measuring 2.9 x 5.9 x 2.9 cm with surrounding edema, 10 mm of midline shift, and subfalcine herniation. A brain MRI re-demonstrated a large, right-sided, heterogeneously enhancing, dural-based, temporal-parietal mass (Figures 1A, 1B).


Molecular and Genetic Predictors of Breast-to-Brain Metastasis: Review and Case Presentation.

Medress Z, Hayden Gephart M - Cureus (2015)

Resection of Dural-based Brain MetastasisPre- and postoperative MRI images demonstrate resection of a breast cancer dural-based metastasis. Preoperative axial T2 (A) and T1 with contrast images (B) show a heterogeneously enhancing 2.9 x 5.9 x 2.9 cm dural-based tumor in the right temporal-parietal region associated with significant peri-tumoral edema and midline shift. Postoperative T2 (C) and T1 with contrast images (D) demonstrate tumor resection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494590&req=5

FIG1: Resection of Dural-based Brain MetastasisPre- and postoperative MRI images demonstrate resection of a breast cancer dural-based metastasis. Preoperative axial T2 (A) and T1 with contrast images (B) show a heterogeneously enhancing 2.9 x 5.9 x 2.9 cm dural-based tumor in the right temporal-parietal region associated with significant peri-tumoral edema and midline shift. Postoperative T2 (C) and T1 with contrast images (D) demonstrate tumor resection.
Mentions: A 59-year-old woman with a five-year history of invasive ductal ER, PR, and HER2/neu-positive breast cancer presented with a history of headache, nausea, and decreased oral intake. The patient had undergone a mastectomy, followed by neoadjuvant chemotherapy (doxorubicin, cyclophosphamide, paclitaxel, trastuzumab, paclitaxel), and radiation. On initial examination, she had decreased orientation and level of consciousness, hemineglect, and left-sided pronator drift. A head CT demonstrated a large right-sided temporal-parietal mass measuring 2.9 x 5.9 x 2.9 cm with surrounding edema, 10 mm of midline shift, and subfalcine herniation. A brain MRI re-demonstrated a large, right-sided, heterogeneously enhancing, dural-based, temporal-parietal mass (Figures 1A, 1B).

Bottom Line: Brain metastases are the most common intracranial malignancy, and breast cancer is the second most common cancer to metastasize to the brain.Intracranial disease is a late manifestation of breast cancer with few effective treatment options, affecting 15-50% of breast cancer patients, depending upon molecular subtype.We believe that advances in the understanding of breast to brain metastasis pathogenesis will lead to targeted molecular therapies and to improvements in the ability to prospectively identify patients at increased risk for developing intracranial disease.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Stanford University.

ABSTRACT
Brain metastases are the most common intracranial malignancy, and breast cancer is the second most common cancer to metastasize to the brain. Intracranial disease is a late manifestation of breast cancer with few effective treatment options, affecting 15-50% of breast cancer patients, depending upon molecular subtype. In this review article, we describe the genetic, molecular, and metabolic changes in breast cancer cells that facilitate breast to brain metastasis. We believe that advances in the understanding of breast to brain metastasis pathogenesis will lead to targeted molecular therapies and to improvements in the ability to prospectively identify patients at increased risk for developing intracranial disease.

No MeSH data available.


Related in: MedlinePlus