Brain Metastases in Breast Cancer

Authors

  • พิมพ์ขวัญ กำเนิดศุภผล หน่วยรังสีรักษาและมะเร็งวิทยา ภาควิชารังสีวิทยา คณะแพทยศาสตร์ มหาวิทยาลัยเชียงใหม่
  • วิชาญ หล่อวิทยา หน่วยรังสีรักษาและมะเร็งวิทยา ภาควิชารังสีวิทยา คณะแพทยศาสตร์ มหาวิทยาลัยเชียงใหม่
  • อิ่มใจ ชิตาพนารักษ์ หน่วยรังสีรักษาและมะเร็งวิทยา ภาควิชารังสีวิทยา คณะแพทยศาสตร์ มหาวิทยาลัยเชียงใหม่
  • เอกสิทธิ์ ธราวิจิตรกุล หน่วยรังสีรักษาและมะเร็งวิทยา ภาควิชารังสีวิทยา คณะแพทยศาสตร์ มหาวิทยาลัยเชียงใหม่
  • วิมล สุขถมยา หน่วยรังสีรักษาและมะเร็งวิทยา ภาควิชารังสีวิทยา คณะแพทยศาสตร์ มหาวิทยาลัยเชียงใหม่

Abstract

Breast cancer is the second most common cancer associated with brain metastases based on the data of the United States. The incidence of brain metastases appears to be rising due to a tendency of longer survival in the advanced breast cancer patients. In particular subsets of patients, disease progression in the central nervous system has become the major life-limiting problem. In general, patients with controlled extracranial or stable disease and patients with human epidermal growth factor receptor 2- positive or estrogen receptor-positive disease tend to have a prolonged survival, and more aggressive treatments should be undertaken in these groups of patients. Symptom management of brain metastases includes control of increased intracranial pressure and peritumoral edema with corticosteroids, treatment and prevention of seizures as well as treatment and prevention of venous thromboembolic disease. For patients with a single central nervous system lesion that is surgically accessible, surgical resection should be recommended. Stereotactic radiosurgery is an option for patients with lesions in surgically inaccessible locations and those who are not surgical candidates. For patients with more than one metastasis, but a limited number (generally less than 4 lesions), treatment is individualized, based upon such factors as tumor size and location, tumor biology, and treatment toxicity. For patients with brain metastases and a poor prognosis (poor performance status or rapidly progressive systemic disease), palliative whole brain irradiation is generally recommended.

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Published

2011-06-29

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กำเนิดศุภผล พ, หล่อวิทยา ว, ชิตาพนารักษ์ อ, ธราวิจิตรกุล เ, สุขถมยา ว. Brain Metastases in Breast Cancer. J Thai Assn of Radiat Oncol [Internet]. 2011 Jun. 29 [cited 2024 Dec. 21];17(1):49-64. Available from: https://he01.tci-thaijo.org/index.php/jtaro/article/view/203485

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