title: Peritoneal disease in breast cancer: a specific entity with an extremely poor prognosis.
abstract: BACKGROUND
  Peritoneal metastases are now a significant cause of morbidity and mortality in patients with advanced breast cancer. There are few published data regarding the prognosis, clinical characteristics and management of individuals with peritoneal metastases from breast cancer.
  
  
  METHODS
  The electronic database at Imperial College Healthcare NHS Trust (Charing Cross Hospital) was searched for the terms 'breast', 'cancer' or 'tumour', 'peritoneal' and 'ascites' from 2000 to 2008. Those with confirmed peritoneal disease from breast cancer, as described on ultrasound or staging CT reports with a clinico-pathologic confirmed diagnosis, were included.
  
  
  RESULTS
  A total of 1628 patients were screened and initially 168 patients were identified. A subsequent total of 44 individuals (2.7% of the cohort) were defined as having breast cancer with peritoneal secondaries and were included in the analysis. Of these, the majority (77%) had invasive ductal carcinomas (IDCs). While the median survival from the diagnosis of metastatic breast cancer measured 20.5 months (range 0.1-125 months), the median survival of patients with peritoneal disease was 1.56 months (range 0.2-27 months).
  
  
  CONCLUSIONS
  These data demonstrate that the median survival of patients with peritoneal breast cancer metastasis is surprisingly poor, with only a minority surviving more than 6 months. A specific association with invasive lobular carcinoma (ILC) was not observed. The dismal outcome of these individuals, despite further active therapy, merits their inclusion into clinical trials designed specifically for this group of patients.
authors.affiliation: Department of Medical Oncology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Tuthill
authors.forename: Robert
authors.initials: R
authors.lastname: Pell
authors.forename: Rosa
authors.initials: R
authors.lastname: Guiliani
authors.forename: Adrian
authors.initials: A
authors.lastname: Lim
authors.forename: Mihir
authors.initials: M
authors.lastname: Gudi
authors.forename: Kaiyumars B
authors.initials: KB
authors.lastname: Contractor
authors.forename: Jacqueline S
authors.initials: JS
authors.lastname: Lewis
authors.forename: R Charles
authors.initials: RC
authors.lastname: Coombes
authors.forename: Justin
authors.initials: J
authors.lastname: Stebbing
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000556:secondary*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary*; D015995:Prevalence; D011379:Prognosis; D055815:Young Adult