Diagnostics and Screening in Breast Cancer with Brain and Leptomeningeal Metastasis: A Review of the Literature

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2024 Nov 9

PMID 39518124

Authors

Adam J Cohen-Nowak

Virginia B Hill

Priya Kumthekar

Affiliations

Soon will be listed here.

Abstract

Brain and leptomeningeal metastases are complications of breast cancer with high rates of morbidity and mortality and have an estimated incidence of up to 30%. While National Comprehensive Cancer Network (NCCN) guidelines recommend screening for central nervous system metastasis in other neurotropic cancers such as non-small cell lung cancer, there are no such recommendations for asymptomatic breast cancer patients at any stage of disease. This review highlights ongoing studies into screening and diagnostics for breast cancer with brain and leptomeningeal metastasis (BCBLM) as they relate to patient outcomes and prognostication. These include imaging methods such as MRI with novel contrast agents with or without PET/CT, as well as 'liquid biopsy' testing of the cerebrospinal fluid and serum to analyze circulating tumor cells, genomic material, proteins, and metabolites. Given recent advances in radiation, neurosurgery, and systemic treatments for BCBLM, screening for CNS involvement should be considered in patients with advanced breast cancer as it may impact treatment decisions and overall survival.

References

Galindo-Hernandez O, Villegas-Comonfort S, Candanedo F, Gonzalez-Vazquez M, Chavez-Ocana S, Jimenez-Villanueva X . Elevated concentration of microvesicles isolated from peripheral blood in breast cancer patients. Arch Med Res. 2013; 44(3):208-14. DOI: 10.1016/j.arcmed.2013.03.002. View

Khan S, Ferguson Bennit H, Turay D, Perez M, Mirshahidi S, Yuan Y . Early diagnostic value of survivin and its alternative splice variants in breast cancer. BMC Cancer. 2014; 14:176. PMC: 3995700. DOI: 10.1186/1471-2407-14-176. View

Pierga J, Bidard F, Cropet C, Tresca P, Dalenc F, Romieu G . Circulating tumor cells and brain metastasis outcome in patients with HER2-positive breast cancer: the LANDSCAPE trial. Ann Oncol. 2013; 24(12):2999-3004. DOI: 10.1093/annonc/mdt348. View

Patel A, Allen J, Dicker D, Peters K, Sheehan J, Glantz M . Identification and enumeration of circulating tumor cells in the cerebrospinal fluid of breast cancer patients with central nervous system metastases. Oncotarget. 2011; 2(10):752-60. PMC: 3248154. DOI: 10.18632/oncotarget.336. View

Fitzpatrick A, Iravani M, Mills A, Childs L, Alaguthurai T, Clifford A . Assessing CSF ctDNA to Improve Diagnostic Accuracy and Therapeutic Monitoring in Breast Cancer Leptomeningeal Metastasis. Clin Cancer Res. 2021; 28(6):1180-1191. PMC: 7612501. DOI: 10.1158/1078-0432.CCR-21-3017. View

Cao T, Dixit K, Santa-Maria C, Kumthekar P . Factors affecting time to brain metastases for stage 2 and 3 breast cancer patients: A large single-institutional analysis with potential screening implications. Neurooncol Adv. 2021; 3(1):vdab009. PMC: 7954098. DOI: 10.1093/noajnl/vdab009. View

Mayr N, Yuh W, Muhonen M, Fisher D, Nguyen H, Ehrhardt J . Cost-effectiveness of high-dose MR contrast studies in the evaluation of brain metastases. AJNR Am J Neuroradiol. 1994; 15(6):1053-61. PMC: 8333458. View

Parkins K, Hamilton A, Makela A, Chen Y, Foster P, Ronald J . A multimodality imaging model to track viable breast cancer cells from single arrest to metastasis in the mouse brain. Sci Rep. 2016; 6:35889. PMC: 5073295. DOI: 10.1038/srep35889. View

Kim D, Heo Y, Jeong H, Baek J, Han J, Lee J . Usefulness of the Delay Alternating with Nutation for Tailored Excitation Pulse with T1-Weighted Sampling Perfection with Application-Optimized Contrasts Using Different Flip Angle Evolution in the Detection of Cerebral Metastases: Comparison with.... AJNR Am J Neuroradiol. 2019; 40(9):1469-1475. PMC: 7048452. DOI: 10.3174/ajnr.A6158. View

10.

Paoletti C, Miao J, Dolce E, Darga E, Repollet M, Doyle G . Circulating Tumor Cell Clusters in Patients with Metastatic Breast Cancer: a SWOG S0500 Translational Medicine Study. Clin Cancer Res. 2019; 25(20):6089-6097. PMC: 6801082. DOI: 10.1158/1078-0432.CCR-19-0208. View

11.

Cristofanilli M . Circulating tumor cells, disease progression, and survival in metastatic breast cancer. Semin Oncol. 2006; 33(3 Suppl 9):S9-14. DOI: 10.1053/j.seminoncol.2006.03.016. View

12.

Togao O, Yoshiura T, Keupp J, Hiwatashi A, Yamashita K, Kikuchi K . Amide proton transfer imaging of adult diffuse gliomas: correlation with histopathological grades. Neuro Oncol. 2013; 16(3):441-8. PMC: 3922507. DOI: 10.1093/neuonc/not158. View

13.

de Azevedo C, Cruz M, Chinen L, Peres S, Peterlevitz M, Pereira A . Meningeal carcinomatosis in breast cancer: prognostic factors and outcome. J Neurooncol. 2011; 104(2):565-72. DOI: 10.1007/s11060-010-0524-y. View

14.

Skogen K, Schulz A, Helseth E, Ganeshan B, Dormagen J, Server A . Texture analysis on diffusion tensor imaging: discriminating glioblastoma from single brain metastasis. Acta Radiol. 2018; 60(3):356-366. DOI: 10.1177/0284185118780889. View

15.

Young J, Ressler J, Mortimer J, Schmolze D, Fitzgibbons M, Chen B . Performance of enhancement on brain MRI for identifying HER2 overexpression in breast cancer brain metastases. Eur J Radiol. 2021; 144:109948. DOI: 10.1016/j.ejrad.2021.109948. View

16.

Niikura N, Hayashi N, Masuda N, Takashima S, Nakamura R, Watanabe K . Treatment outcomes and prognostic factors for patients with brain metastases from breast cancer of each subtype: a multicenter retrospective analysis. Breast Cancer Res Treat. 2014; 147(1):103-12. DOI: 10.1007/s10549-014-3090-8. View

17.

De Mattos-Arruda L, Mayor R, Ng C, Weigelt B, Martinez-Ricarte F, Torrejon D . Cerebrospinal fluid-derived circulating tumour DNA better represents the genomic alterations of brain tumours than plasma. Nat Commun. 2015; 6:8839. PMC: 5426516. DOI: 10.1038/ncomms9839. View

18.

Zhou Y, Zhou J, Hao X, Shi H, Li X, Wang A . Efficacy relevance of PD-L1 expression on circulating tumor cells in metastatic breast cancer patients treated with anti-PD-1 immunotherapy. Breast Cancer Res Treat. 2023; 200(2):281-291. DOI: 10.1007/s10549-023-06972-6. View

19.

Xenidis N, Ignatiadis M, Apostolaki S, Perraki M, Kalbakis K, Agelaki S . Cytokeratin-19 mRNA-positive circulating tumor cells after adjuvant chemotherapy in patients with early breast cancer. J Clin Oncol. 2009; 27(13):2177-84. DOI: 10.1200/JCO.2008.18.0497. View

20.

Mills M, Potluri T, Kawahara Y, Fahey M, Figura N, Soyano A . The presentation of brain metastases in melanoma, non-small cell lung cancer, and breast cancer and potential implications for screening brain MRIs. Breast Cancer Res Treat. 2021; 191(1):209-217. DOI: 10.1007/s10549-021-06420-3. View