Adam S Komorowski1, Ellen Warner2, Helen J MacKay2, Arjun Sahgal3, Kathleen I Pritchard2, Katarzyna J Jerzak4. 1. Division of Medical Microbiology, McMaster University, Hamilton, Ontario, Canada. 2. Division of Medical Oncology and Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada. 3. Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada. 4. Division of Medical Oncology and Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada. Electronic address: katarzyna.jerzak@sunnybrook.ca.
Abstract
BACKGROUND: Current National Comprehensive Cancer Network and American Society of Clinical Oncology guidelines recommend against screening breast cancer patients for asymptomatic brain metastases. Because brain metastases are a major cause of morbidity and mortality from breast cancer, we undertook a literature review to ascertain whether there might be a role for brain metastases screening in high-risk patient subgroups. MATERIALS AND METHODS: A literature search was conducted on the OvidSP platform in the MedLine database, using MeSH terms and subject headings related to breast cancer, brain metastases, and incidence. The search was conducted without language or publication restrictions, and included articles indexed from January 1, 2006 to June 10, 2018. Experimental and observational studies that reported the incidence of brain metastases in patients with nonmetastatic or metastatic breast cancer were included. RESULTS: One hundred seventy studies were identified, with 33 included in the final analysis. Among nonmetastatic breast cancer patients, incidence of brain metastases as site of first recurrence per year of median follow-up ranged from 0.1% to 3.2%. Although incidence of brain metastases was much higher among the metastatic breast cancer population overall, it was particularly high among metastatic HER2-overexpressing (HER2+) and triple-negative populations, ranging between 22% and 36% for the former, and 15%-37% for the latter in the absence of screening. CONCLUSION: In patients with nonmetastatic breast cancer, screening for asymptomatic brain metastases cannot currently be justified. However, due to the high incidence of brain metastases among patients with metastatic HER2+ and triple-negative breast cancer, studies to determine the value of screening for brain metastases should be undertaken in these subgroups.
BACKGROUND: Current National Comprehensive Cancer Network and American Society of Clinical Oncology guidelines recommend against screening breast cancerpatients for asymptomatic brain metastases. Because brain metastases are a major cause of morbidity and mortality from breast cancer, we undertook a literature review to ascertain whether there might be a role for brain metastases screening in high-risk patient subgroups. MATERIALS AND METHODS: A literature search was conducted on the OvidSP platform in the MedLine database, using MeSH terms and subject headings related to breast cancer, brain metastases, and incidence. The search was conducted without language or publication restrictions, and included articles indexed from January 1, 2006 to June 10, 2018. Experimental and observational studies that reported the incidence of brain metastases in patients with nonmetastatic or metastatic breast cancer were included. RESULTS: One hundred seventy studies were identified, with 33 included in the final analysis. Among nonmetastatic breast cancerpatients, incidence of brain metastases as site of first recurrence per year of median follow-up ranged from 0.1% to 3.2%. Although incidence of brain metastases was much higher among the metastatic breast cancer population overall, it was particularly high among metastatic HER2-overexpressing (HER2+) and triple-negative populations, ranging between 22% and 36% for the former, and 15%-37% for the latter in the absence of screening. CONCLUSION: In patients with nonmetastatic breast cancer, screening for asymptomatic brain metastases cannot currently be justified. However, due to the high incidence of brain metastases among patients with metastatic HER2+ and triple-negative breast cancer, studies to determine the value of screening for brain metastases should be undertaken in these subgroups.
Authors: Ninke E A Wellerdieck; Peter Wessels; Maartje Los; Gabe S Sonke; Ellen Tromp; Dieta Brandsma Journal: Breast Cancer Res Treat Date: 2022-06-09 Impact factor: 4.872
Authors: Desmond A Brown; Victor M Lu; Benjamin T Himes; Terry C Burns; Alfredo Quiñones-Hinojosa; Kaisorn L Chaichana; Ian F Parney Journal: Clin Exp Metastasis Date: 2020-01-16 Impact factor: 5.150
Authors: Yizhuo Kelly Gao; Markus Kuksis; Badr Id Said; Rania Chehade; Alex Kiss; William Tran; Faisal Sickandar; Arjun Sahgal; Ellen Warner; Hany Soliman; Katarzyna J Jerzak Journal: Oncologist Date: 2021-09-21
Authors: Filipa D Oliveira; Marco Cavaco; Tiago N Figueira; Javier Valle; Vera Neves; David Andreu; Diana Gaspar; Miguel A R B Castanho Journal: FEBS J Date: 2021-11-07 Impact factor: 5.622
Authors: Steven Habbous; Katharina Forster; Gail Darling; Katarzyna Jerzak; Claire M B Holloway; Arjun Sahgal; Sunit Das Journal: Neurooncol Adv Date: 2020-12-22
Authors: Markus Kuksis; Yizhuo Gao; William Tran; Christianne Hoey; Alex Kiss; Adam S Komorowski; Aman J Dhaliwal; Arjun Sahgal; Sunit Das; Kelvin K Chan; Katarzyna J Jerzak Journal: Neuro Oncol Date: 2021-06-01 Impact factor: 12.300