Occult central nervous system involvement in patients with metastatic breast cancer: Prevalence, predictive factors and impact on overall survival Journal Article
| Authors: | Miller, K. D.; Weathers, T.; Haney, L. G.; Timmerman, R.; Dickler, M.; Shen, J.; Sledge, G. W. Jr |
| Article Title: | Occult central nervous system involvement in patients with metastatic breast cancer: Prevalence, predictive factors and impact on overall survival |
| Abstract: | Background: As screening central nervous system (CNS) imaging is not routinely performed, the incidence and clinical relevance of occult CNS metastases in advanced breast cancer is unknown. Patients and methods: All patients screened for participation in one of four clinical trials were included; each of the trials excluded patients with known CNS involvement and required screening CNS imaging. A cohort of breast cancer patients with symptomatic CNS metastases was identified from the IU Cancer Center Tumor Registry for comparison. Results: From November 1998 to August 2001, 155 screening imaging studies were performed. Twenty-three patients (14.8%) had occult CNS metastases. HER-2 overexpression (P=0.02) and number of metastatic sites (P=0.03) were predictive of CNS involvement by multivariate analysis. Median survival from time of metastasis (1.78 versus 2.76 years; P<0.0001) and from screening (4.67 versus 10.4 months; P=0.0013) was shorter in patients with than without occult CNS metastasis. Survival among patients with occult CNS metastasis was similar to patients with symptomatic CNS disease. Conclusions: Patients with CNS involvement, whether occult or symptomatic, have an impaired survival. Occult CNS metastasis is relatively common, but impact on survival of treating occult CNS disease in patients with progressive systemic metastases is questionable. |
| Keywords: | vasculotropin; adult; cancer survival; controlled study; aged; middle aged; survival analysis; major clinical study; clinical trial; angiogenesis inhibitor; cancer risk; monotherapy; capecitabine; paclitaxel; cancer patient; nuclear magnetic resonance imaging; cancer incidence; prospective studies; gene overexpression; metastasis; computer assisted tomography; controlled clinical trial; breast cancer; prevalence; tumor markers, biological; cohort analysis; cancer screening; mass screening; diagnostic imaging; breast neoplasms; prediction; central nervous system; central nervous system neoplasms; docetaxel; monoclonal antibody; cancer center; gene expression regulation, neoplastic; registries; recombinant antibody; predictive value of tests; cancer registry; epirubicin; receptor, erbb-2; multivariate analysis; taxane derivative; anthracycline; clinical trials; oncogene neu; central nervous system metastasis; occult cancer; natural history; humans; prognosis; human; female; priority journal; article |
| Journal Title: | Annals of Oncology |
| Volume: | 14 |
| Issue: | 7 |
| ISSN: | 0923-7534 |
| Publisher: | Oxford University Press |
| Date Published: | 2003-07-01 |
| Start Page: | 1072 |
| End Page: | 1077 |
| Language: | English |
| DOI: | 10.1093/annonc/mdg300 |
| PUBMED: | 12853349 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
