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

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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) , Connolly, RM, Rosset, L, Arcuri, J, Tesch, H, Vallejos, C, Retamales, J, Musolino, A, DelMastro, 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 (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-. ISSN 2059-7029, 2059-7029

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Abstract

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:	Article
Uncontrolled Keywords:	breast cancer, carcinomatous meningitis
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Systems, Molec & Integrative Biology > Inst. Systems, Molec & Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	15 Jul 2022 14:34
Last Modified:	16 Jun 2026 12:17
DOI:	10.1016/j.esmoop.2022.100483
Open Access URL:	https://doi.org/10.1016/j.esmoop.2022.100483
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3158584
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