Abstract Details

Title Leptomemigeal Dissemination in Breast Cancer Patients Clinical and Pathological Characteristics

Topic Neuro-oncology

Presentation(s) S56 - (-)

Poster/Presentation
Number 004

Objective

Background Leptomeningeal dissemination(LMD) occurs in 5% of breast cancer patients.

Design/Methods A retrospective analysis of breast cancer patients with LMD who were evaluated in MDACC between 1995 and 2011 was performed. 104 patients with diagnosis of breast cancer with LMD were identified. Only one patient was male.

Results The mean age at LMD diagnosis was 49.7 years (range 28-76). Most patients had invasive ductal carcinoma (78.2%). Estrogen and progesterone receptors were positive in 49.5% and 62.1% of patients, respectively, and 47.4% were HER-2-positive. CSF cytology was positive in 90% and MRI was positive for LMD in 86% of the cases. 52% of the patients were treated with WBRT, 20% were treated with spinal radiation. 36% were treated with systemic chemotherapy and 55% were treated with intrathecal chemotherapy. Estimated overall survival from time of breast cancer diagnosis was 3.66 years, one patient is still alive. Median survival duration from time of LMD diagnosis was 4.2 months. Time from breast cancer diagnosis to LMD was 2.48 years. In multivariate analysis receptor status (ER/PR/HER-2) and stage at diagnosis were significantly associated with time to LMD diagnosis (p<0.05). Time to LMD was shorter in Triple negative patients and longer in patients who were ER or PR positive. Once LMD was diagnosed, in multivariate analysis, treatment was the only significant factor associated with improved overall survival from LMD diagnosis (p<0.05).

Conclusions LMD has dismal prognosis in breast cancer patients. Receptor status and stage at diagnosis are the most important factors contributing to time to LMD diagnosis. However once LMD is diagnosed receptor status losses its importance and only treatment effects survival.

Authors/Disclosures
Pedro Garciarena, MD (Collier Neurologic Specialist, LLC) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Morris D. Groves, Jr., MD	No disclosure on file
Bruce S. Rubin, MD, FAAN (Design Neuroscience Center)	No disclosure on file

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