Stereotactic Radiosurgery as Part of Multimodal Treatment in a Bulky Leptomeningeal Recurrence of Breast Cancer

Breast cancer metastatic to the brain and/or leptomeningeal spread of disease is a frequently encountered clinical situation, especially given the extended course of disease in these patients. Systemic therapies can often effectively prolong extracranial disease control, making effective strategies...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2016-03, Vol.8 (3), p.e523
Main Authors: Bertke, Matthew H, Burton, Eric C, Shaughnessy, Joseph N
Format: Article
Language:English
Subjects:
Breast cancer
Case reports
Neurosurgery
Oncology
Radiation Oncology
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Summary:Breast cancer metastatic to the brain and/or leptomeningeal spread of disease is a frequently encountered clinical situation, especially given the extended course of disease in these patients. Systemic therapies can often effectively prolong extracranial disease control, making effective strategies to control central nervous system-based disease even more critical. We present a case of bulky leptomeningeal relapse of breast cancer in the setting of prior whole brain radiation therapy. In order to treat the patient's bulky disease and leptomeningeal spread while avoiding the potential toxicities of repeat whole brain radiation, the patient was treated with frameless stereotactic radiosurgery and intrathecal chemotherapy. This is the first report of this treatment approach for leptomeningeal relapse of breast cancer. The patient had an excellent response to treatment and durable intracranial control.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.523