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[The incidence of central nervous system metastasis from primary breast cancer has steadily increased with aggressive chemotherapy resulting in improved long-term survival. Brain metastases are more common among those with more aggressive histological subtypes of breast cancer such as triple negative and HER2-positive subtypes. Effectiveness of pharmacological treatment for brain metastases is hindered by the blood–brain barrier. As such, current standard-of-care treatment modalities for CNS metastases include microsurgical resection, whole-brain radiation therapy, and stereotactic radiosurgery, either alone or in combination. Despite providing good local control, involvement of the CNS remains a devastating complication of breast cancer significantly limiting patient survival and quality of life. Leptomeningeal disease is a particularly devastating neurological complication of breast cancer and has limited treatment options. Overall prognosis of breast cancer brain metastasis remains dismal with 1- and 2-year survival rates of 20 % and 2 %, respectively. Clearly, there is a dire need to identify biomarkers permitting earlier and accurate diagnosis of CNS metastases, development of prevention strategies in high-risk individuals, and establishing more effective treatment options such as targeted systemic and intrathecal therapies.]
Published: Sep 6, 2014
Keywords: Brain metastases; Blood–brain barrier; Central nervous system; Treatment; Surgery; Radiosurgery; Whole-brain radiation therapy; Leptomeningeal disease; Clinical trials
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