[Neurosurgical treatment of patients with parenchymal brain metastases from breast carcinoma].
Breast cancer in women is the most common source of parenchymal brain metastases and takes the second place in brain matastasing neoplasms. The goal of this publication is to analyse the patients with parenchymal brain metastases who have been operated in the Department of Neurosurgery in last 10 years and match the results with literature datum.


METHODS
Analysis was made for 28 patients with parenchymal brain metastases from breast cancer who underwent neurosurgical operations in a 10-years period (1995-2004). All of them are female. The diagnosis was made according to neurological status, neuroimages and histological verification. Seven patients underwent image-guided metastasectomy. The postoperative complications were divided into neurological, regional and systemic.


RESULTS
The clinical rate of patients with parenchymal brain metastases is 16%. Premenopausal age is predominating. Multiple and single metastases are equally. All of brain metastases are metachronous and parietal lobe is most often involved. The patients in prognostic class II of Gaspar classification are prevalent. Postoperative outcome in 25% is found to be poor. Seven image-guided craniotomy was made and two of them completed with one-staged bimetastasectomies.


CONCLUSIONS
The breast cancer is a disease with frequent late and multiple recidivating brain metastases. Mean-effective methods such chemo- and radiotherapy make neurosurgery and especially image-guided neurosurgery the most effective treatment of cerebral lesions. One-staged image-guided metastasectomy may benefit patients with oligometastatic brain disease and good performance statuses.
Eftimov
T
T
Petkov
A
A
Stoev
I
I
Ivanov
I
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011859:Radiography; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome