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



Razis, E, Escudero, MJ, Palmieri, C ORCID: 0000-0001-9496-2718, Mueller, V, Bartsch, R, Rossi, G, Gampenrieder, SP, Kolberg, HC, Zdenkowski, N, Pavic, M
et al (show 24 more authors) (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-.

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Abstract

<h4>Background</h4>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.<h4>Patients and methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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: Article
Uncontrolled Keywords: Humans, Breast Neoplasms, Brain Neoplasms, Skin Neoplasms, Medical Oncology, Female, Meningeal Carcinomatosis
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 15 Jul 2022 14:34
Last Modified: 18 Jan 2023 20:56
DOI: 10.1016/j.esmoop.2022.100483
Open Access URL: https://doi.org/10.1016/j.esmoop.2022.100483
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3158584