Is early recognition of radiologically silent brain metastasis from breast cancer beneficial? A retrospective study of 22 cases

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dc.contributor.author Mystakidou, K en
dc.contributor.author Kouloulias, V en
dc.contributor.author Tsilika, E en
dc.contributor.author Boviatsis, E en
dc.contributor.author Kouvaris, J en
dc.contributor.author Matsopoulos, G en
dc.contributor.author Vlahos, L en
dc.date.accessioned 2014-03-01T01:20:41Z
dc.date.available 2014-03-01T01:20:41Z
dc.date.issued 2004 en
dc.identifier.issn 13406868 en
dc.identifier.uri http://hdl.handle.net/123456789/16012
dc.subject Brain metastasis en
dc.subject Breast cancer en
dc.subject Early symptoms en
dc.subject Increased intracranial pressure en
dc.subject Radiotherapy en
dc.subject.other aged en
dc.subject.other article en
dc.subject.other brain en
dc.subject.other brain tumor en
dc.subject.other breast tumor en
dc.subject.other comparative study en
dc.subject.other computer assisted tomography en
dc.subject.other female en
dc.subject.other follow up en
dc.subject.other human en
dc.subject.other metastasis en
dc.subject.other middle aged en
dc.subject.other nuclear magnetic resonance imaging en
dc.subject.other pathology en
dc.subject.other retrospective study en
dc.subject.other survival en
dc.subject.other time en
dc.subject.other Aged en
dc.subject.other Brain en
dc.subject.other Brain Neoplasms en
dc.subject.other Breast Neoplasms en
dc.subject.other Female en
dc.subject.other Follow-Up Studies en
dc.subject.other Humans en
dc.subject.other Magnetic Resonance Imaging en
dc.subject.other Middle Aged en
dc.subject.other Retrospective Studies en
dc.subject.other Survival Analysis en
dc.subject.other Time Factors en
dc.subject.other Tomography, X-Ray Computed en
dc.title Is early recognition of radiologically silent brain metastasis from breast cancer beneficial? A retrospective study of 22 cases en
heal.type journalArticle en
heal.identifier.primary 10.1007/BF02984549 en
heal.identifier.secondary http://dx.doi.org/10.1007/BF02984549 en
heal.publicationDate 2004 en
heal.abstract Over a period of 10 years, twenty-two patients with T2-3N2Mx breast cancer presented with symptoms of increased intracranial pressure (ICP), but brain CT scan and/or MRI didnot reveal any signs of a space occupying lesion. A brain CT scan and an MRI study were performed every 15 days. Ten patients refused this close follow up. Thus, two groups were formed group A (n = 12) included the patients who were close's followed and group B (n = 10) consisted of those patients who were not. Therefore, Group A, being under careful follow-up, initiated radiotherapy were quickly. The median time from the presentation of increased ICP symptoms until the appearance of metastases on CT and/or MRI directly followed by brain irradiation was 48 days (SE = 6.1) for group A and 72 days (SE = 0.7) for group B (p = 0.0085, log-rank test). In group A, median Overall Survival (OS) was 171.0 (SE = 21.5) days, and was 99.0 (SE = 6.3) days (p = 0.014) for group B. Volumetric analysis of the secondary brain lesions at the initiation of radiotherapy showed a total volume of metastatic lesions of 19.5 -+ 13.9 cm 3 versus 65.3 -+ 20.7 cm 3 for groups A and B, respectively (p < 0.001, Mann-Whitney test). Post-radiotherapy, Karnofsky Performance Status and Visual Analogue Score were also improved for group A versus B (p = 0.002). Group A appeared to benefit from close follow-up since the metastases were detected and irradiation was given sooner compared with group B, thus achieving better performance status and prolonged survival. Radiologically silent brain metastases from breast cancer should not be ignored because timely whole brain irradiation should be the goal of clinicians. Clinical suspicion should lead to close follow-up with multiple CT/MRI studies and cerebral spinal fluid cytology until the final diagnosis. en
heal.journalName Breast Cancer en
dc.identifier.doi 10.1007/BF02984549 en
dc.identifier.volume 11 en
dc.identifier.issue 3 en
dc.identifier.spage 276 en
dc.identifier.epage 281 en

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