A number of prognostic factors have emerged from a retrospective study of 83 patients with breast cancer associated with a solid intracerebral tumour (59%), or meningeal invasion (33%) or both (8%). The median survival was 4 months without significant difference between breast tumours and meningeal carcinomatosis. Women in pre-menopause at the initial diagnosis of breast cancer (P less than or equal to 0.05) or who were 50 years of age when the cerebral metastasis occurred (P less than or equal to 0.05) or who had only one metastasis (P less than or equal to 0.02) had a better prognosis. During meningeal carcinomatosis, CSF protein and carcinoembryonic antigen levels have no prognostic value. All patients with intracerebral tumour had been irradiated (40 Gy over 4 weeks). The tumour was removed whenever possible. Intrathecal or systemic chemotherapy and hormone therapy seem to be favourable prognostic factors. This would suggest that chemotherapy may increase the survival of patients with this type of breast cancer, but only randomized studies will demonstrate its true effectiveness.
Brain Neoplasms Breast Neoplasms