title: Leptomeningeal carcinomatosis as the primary presentation of relapse in breast cancer.
abstract: Leptomeningeal metastasis (LM) is an uncommon presentation of relapse in breast cancer, which is associated with poor clinical outcomes and poor prognosis. Notably, LM most commonly occurs in breast cancer. The aim of the present review was to investigate the occurrence of LM as the primary presentation of relapse following remission in breast cancer patients and to determine whether specific histological subtypes are predisposed to meningeal metastases. In addition, the present review evaluated whether patients presenting with LM as the primary site of relapse exhibit differences in survival when compared with patients exhibiting metastasis to other sites. Cross-sectional studies have demonstrated that LM is commonly associated with other sites of distant metastasis including lung, liver and bone metastases. The histological breast cancer subtype most commonly associated with LM was invasive lobular carcinoma, while triple-negative breast cancer patients appear to be predisposed to the development of LM when considering the overall prevalence of histological breast cancer subtypes. At present, data regarding LM as the primary site of relapse are limited due to its rarity as the first site of metastasis in breast cancer. Case-controlled studies are required to investigate the incidence of LM as the primary site of recurrence in breast cancer patients as this would enable treatment standardization and identification of prognostic factors for improved survival.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Sacco
authors.affiliation: Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.
authors.forename: Aun
authors.initials: A
authors.lastname: Muhammad
authors.affiliation: Mont Vernon Hospital, Middlesex HA6 2RN, UK.
authors.forename: Waqar
authors.initials: W
authors.lastname: Saleem
authors.affiliation: Faculty of Pharmacy and Medical Sciences, Petra University, Amman 00962, Jordan.
authors.forename: Heba
authors.initials: H
authors.lastname: Alshaker
authors.affiliation: Department of Imaging, St Mary's Hospital, London W2 1NY, UK.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Monzon
authors.affiliation: Guys and St Thomas Hospital, London SE1 9RT, UK.
authors.forename: Mohammad Rafiqul
authors.initials: MR
authors.lastname: Islam
authors.affiliation: School of Medicine, University of East Anglia, Norwich NR4 7TJ, UK.
authors.forename: Dmitri
authors.initials: D
authors.lastname: Pchejetski
keywords: breast cancer; invasive lobular cancer; leptomeningeal metastasis; triple negative breast cancer