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01-09-2019 | Breast Cancer | Review

Breast leptomeningeal disease: a review of current practices and updates on management

Authors: Nicholas B. Figura, Victoria T. Rizk, Avan J. Armaghani, John A. Arrington, Arnold B. Etame, Hyo S. Han, Brian J. Czerniecki, Peter A. Forsyth, Kamran A. Ahmed

Published in: Breast Cancer Research and Treatment | Issue 2/2019

Abstract

Purpose

Leptomeningeal disease (LMD) is an advanced metastatic disease presentation portending a poor prognosis with minimal treatment options. The advent and widespread use of new systemic therapies for metastatic breast cancer has improved systemic disease control and extended survival; however, as patients live longer, the rates of breast cancer LMD are increasing.

Methods

In this review, a group of medical oncologists, radiation oncologists, radiologists, breast surgeons, and neurosurgeons specializing in treatment of breast cancer reviewed the available published literature and compiled a comprehensive review on the current state of breast cancer LMD.

Results

We discuss the pathogenesis, epidemiology, diagnosis, treatment options (including systemic, intrathecal, surgical, and radiotherapy treatment modalities), and treatment response evaluation specific to breast cancer patients. Furthermore, we discuss the controversies within this unique clinical setting and identify potential clinical opportunities to improve upon the diagnosis, treatment, and treatment response evaluation in the management of breast LMD.

Conclusions

We recognize the shortcomings in our current understanding of the disease and explore the future role of genomic/molecular disease characterization, technological innovations, and ongoing clinical trials attempting to improve the prognosis for this advanced disease state.

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Title: Breast leptomeningeal disease: a review of current practices and updates on management
Authors: Nicholas B. Figura
Victoria T. Rizk
Avan J. Armaghani
John A. Arrington
Arnold B. Etame
Hyo S. Han
Brian J. Czerniecki
Peter A. Forsyth
Kamran A. Ahmed
Publication date: 01-09-2019
Publisher: Springer US
Keywords: Breast Cancer
Methotrexate
Meningitis
Methotrexate
Breast Cancer
Trastuzumab
Cytostatic Therapy
Published in: Breast Cancer Research and Treatment / Issue 2/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-019-05317-6

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