Abstract Details

Title Systematic Review of Intramedullary Metastases in Breast Cancer

Topic Neuro-oncology

Presentation(s) P07 - (-)

Poster/Presentation
Number 015

Objective

Background BACKGROUND: Breast cancer is the second most common cause of intramedullary metastases. Progressive neurologic disability often results. The prognosis is generally poor. A comprehensive review of this subject has not been published previously.

Design/Methods DESIGN/METHODS: This systematic literature search used Pubmed and Yale library search engines. A total of 34 publications were found, encompassing 297 patients with IMM from which 87(29.29%) had metastasis from breast cancer.

Results RESULTS: The mean age of the patients was 50.5 years (range 42-66). Of 52 patients where the location of the tumor was defined, 46 (88.5%) were solitary. The location of the lesion was cervical in 20, thoracic in 13, thoracolumbar in 3 and lumbar in 11 patients. Concurrent brain metastesis was present in 37(42.5%) patients. The most common symptoms were weakness in 21(24%), sensory loss 15(17%), neck or back pain 18(21%) and urinary incontinence 12(14%). In 17 patients cerebrospinal fluid (CSF) findings were reported had elevated protein (mean 182.25 mg/dl; range 66-342 mg/dl). One patient had malignant cells in CSF. The interval from diagnosis of breast cancer to IMM ranged from 9-96 months (mean 48 months) and survival ranged from 2.5- 44 months (mean 14). Tumor markers; ER, PR and HER2 were reported in 8 patients. Local radiation, surgical resection, stereotactic radiosurgery and medical therapy were all applied in treatment.

Conclusions CONCLUSIONS: Breast cancer comprises approximately one third of all intramedullary metastasis . Presence of brain and systemic metastasis as well as size of intramedullary tumor correlate with less favorable prognosis. The data on tumor markers is still insufficient for prognostication .

Authors/Disclosures
Rezvan Rostami, MD (Yale University School of Medicine) PRESENTER	No disclosure on file
Shivam O. Mittal, MD, FAAN (Cleveland Clinic Abu Dhabi)	Dr. Mittal has nothing to disclose.
	No disclosure on file
Bahman Jabbari, MD, FAAN	Dr. Jabbari has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Jabbari has received publishing royalties from a publication relating to health care.
Volker A. Knappertz, MD (Lacum Neurology)	Dr. Knappertz has received personal compensation for serving as an employee of Noema Pharmaceuticals . Dr. Knappertz has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Sutura Pharmaceutical . Dr. Knappertz has received intellectual property interests from a discovery or technology relating to health care.

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