Departments of Breast Medical Oncology and Systems Biology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Oncologist. 2013 Jun;18(6):675-84. doi: 10.1634/theoncologist.2012-0438. Epub 2013 Jun 5.
Metastasis to the central nervous system (CNS) is a devastating neurological complication of systemic cancer. Brain metastases from breast cancer have been documented to occur in approximately 10%-16% of cases over the natural course of the disease with leptomeningeal metastases occurring in approximately 2%-5% of cases of breast cancer. CNS metastases among women with breast cancer tend to occur among those who are younger, have larger tumors, and have a more aggressive histological subtype such as the triple negative and HER2-positive subtypes. Treatment of CNS metastases involves various combinations of whole brain radiation therapy, surgery, stereotactic radiosurgery, and chemotherapy. We will discuss the progress made in the treatment and prevention of breast cancer-associated CNS metastases and will delve into the biological underpinnings of CNS metastases including evaluating the role of breast tumor subtype on the incidence, natural history, prognostic outcome, and impact of therapeutic efficacy.
癌症转移至中枢神经系统（CNS）是一种严重的神经系统并发症，可由全身性癌症引起。据文献记载，乳腺癌脑转移的发生率约为 10%-16%，而脑膜转移的发生率约为 2%-5%。在患有乳腺癌的女性中，CNS 转移倾向于发生在年龄较小、肿瘤较大且组织学亚型更具侵袭性的患者中，如三阴性和 HER2 阳性亚型。CNS 转移的治疗涉及全脑放疗、手术、立体定向放射外科和化疗等多种组合。我们将讨论在治疗和预防乳腺癌相关 CNS 转移方面取得的进展，并深入探讨 CNS 转移的生物学基础，包括评估乳腺癌肿瘤亚型在发病率、自然史、预后结果和治疗效果影响方面的作用。
