title: Progress in the biological understanding and management of breast cancer-associated central nervous system metastases.
abstract: Metastasis to the central nervous system (CNS) is a devastating neurological complication of systemic cancer. Brain metastases from breast cancer have been documented to occur in approximately 10%-16% of cases over the natural course of the disease with leptomeningeal metastases occurring in approximately 2%-5% of cases of breast cancer. CNS metastases among women with breast cancer tend to occur among those who are younger, have larger tumors, and have a more aggressive histological subtype such as the triple negative and HER2-positive subtypes. Treatment of CNS metastases involves various combinations of whole brain radiation therapy, surgery, stereotactic radiosurgery, and chemotherapy. We will discuss the progress made in the treatment and prevention of breast cancer-associated CNS metastases and will delve into the biological underpinnings of CNS metastases including evaluating the role of breast tumor subtype on the incidence, natural history, prognostic outcome, and impact of therapeutic efficacy.
authors.affiliation: Departments of Breast Medical Oncology and Systems Biology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. Shaheenah@post.harvard.edu
authors.forename: Shaheenah
authors.initials: S
authors.lastname: Dawood
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gonzalez-Angulo
mesh_terms: D001812:Blood-Brain Barrier; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D016634:Radiosurgery; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D016896:Treatment Outcome
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Biology; Breast cancer; CNS metastases; Leptomeningeal disease; Treatment