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

Mystakidou, K; Kouloulias, V; Tsilika, E; Boviatsis, E; Kouvaris, J; Matsopoulos, G; Vlahos, L

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	https://dspace.lib.ntua.gr/xmlui/handle/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