CENTRAL NERVOUS INVOLVEMENT (CNI) IN PATIENTS WITH METASTATIC BREAST-CANCER

We reviewed the records of 233 patients with metastatic breast cancer and found 52 with CNI: 34 patients had brain metastases, 12 meningeosis carcinomatosa, and 6 had both brain metastases and meningeosis carcinomatosa. The brain metastases were mostly found in the infratentorial region. Patients developing CNI were younger with a median age of 46 years and in 59.6% premenopausal. Median time from presentation to CNI was 41 months. CNI was the only site of disease in one patient, whereas all others had additional metastases. Leading clinical manifestations in patients with brain metastases were headache, nausea, and dizziness; in patients with meningeosis carcinomatosa also headache, double image, confusion, and apathy. Median survival with chemotherapy and radiotherapy of patients with meningeosis carcinomatosa was 8 months, of patients with brain metastases 4.5 months. More than half of the patients had a marked improvement or complete relief of complaints with chemo/radiotherapy. Median overall survival of patients with CNI was 57 months and of patients without CNI 84 months.