title: Prognostic Markers and Histologic Subtypes in Patients with Meningeal Carcinomatosis in Breast Cancer.
abstract: OBJECTIVE
  Meningeal carcinomatosis (MC) is a rare complication in breast cancer patients. It is defined as a diffuse or multifocal leptomeningeal metastasis.
  
  
  METHODS
  From our institution database, we retrospectively studied 19 patients diagnosed with MC in the cerebrospinal fluid (CSF) in 1997-2015, in order to evaluate tumor prognostic markers, histologic subtypes, and clinical outcome.
  
  
  RESULTS
  All patients were female, with a mean age of 53 years (range 36-75 years). The mean interval between diagnosis of breast carcinoma and MC was 28 months (range 6-62 months). The median survival from the time of diagnosis was 2 months (1-51 months). Sixteen cases (84%) were the ductal phenotype, 62% of which were of a high grade (grade 3), and 3 cases (16%) were lobular. Estrogen and progesterone receptors were positive on immunohistochemistry (IHC) in 53 and 33% of patients, respectively. HER2 IHC was positive (3+) in 20% of the cases; all were amplified by fluorescence in situ hybridization. The incidence of MC in triple-negative tumors was 40%. Twelve patients (63%) already had known metastasis at the time of diagnosis.
  
  
  CONCLUSIONS
  Most cases of MC are high-grade ductal. MC is more common in triple-negative breast cancers. The outcome of these breast cancer patients with MC was poor. There was no survival difference according to age, histologic subtype, grade, or hormonal or HER2 status.
authors.affiliation: Department of Pathology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Hussein
authors.initials: H
authors.lastname: Alnajar
authors.forename: Lauren
authors.initials: L
authors.lastname: Rosen
authors.forename: Sara
authors.initials: S
authors.lastname: Javidiparsijani
authors.forename: Yahya
authors.initials: Y
authors.lastname: Al-Ghamdi
authors.forename: Paolo
authors.initials: P
authors.lastname: Gattuso
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D001706:Biopsy; D001943:Breast Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry / Q000401:mortality / Q000556:secondary*; D018275:Carcinoma, Lobular / Q000737:chemistry / Q000401:mortality / Q000556:secondary*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007087:Illinois; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D055756:Meningeal Carcinomatosis / Q000401:mortality / Q000556:secondary*; D008875:Middle Aged; D060787:Neoplasm Grading; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis / Q000235:genetics; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D064726:Triple Negative Breast Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: Breast cancer; Cerebrospinal fluid cytology; Meningeal carcinomatosis