Abstract:
Breast cancer is one of the most common malignancies among women worldwide. According to the International Agency for Research on Cancer, breast cancer affected more Chinese women than any other cancer in 2020. The brain is an increasingly common metastatic sites of breast cancer. Although the risk of developing brain metastases (BMs) is lower in breast cancer than in lung cancer and melanoma, due to its high prevalence, it is the second most common cause of BM among solid tumors, being second only to lung cancer. The incidence of breast cancer brain metastasis (BCBM) differs by molecular subtype. Half of patients with advanced human epidermal growth factor receptor-2 (HER2)-positive and one-third of patients with triple-negative breast cancer (TNBC) develop BM. The clinical manifestations of leptomeningeal metastasis (LM) are often non-specific and may manifest as a variety of signs and symptoms, mainly including brain parenchyma involvement and meningeal irritation syndromes cranial nerve involvement, increased intracranial pressure, and progressive brain dysfunction. Therefore, the Chinese Society of Clinical Oncology (CSCO) Breast Cancer Committee has developed this expert consensus on BM, in an effort to improve the overall prognosis of BCBM and promote the standardized diagnosis and treatment of this disease. During the development of this expert consensus, we carried out a comprehensive literature review and referred to some of the most authoritative guidelines in China and abroad. In this consensus, we will discuss clinical manifestations, imaging examinations, pathological diagnosis, treatments, prognosis, follow-up and monitoring. We hope this consensus will be of help to all the clinicians majored in breast cancer and other similar professions.
摘要:
乳腺癌是全世界女性中最常见的恶性肿瘤之一。根据国际癌症研究机构,在2020年,乳腺癌对中国女性的影响超过任何其他癌症。大脑是乳腺癌越来越常见的转移部位。尽管乳腺癌发生脑转移(BMs)的风险低于肺癌和黑色素瘤,由于其患病率高,它是实体肿瘤中第二常见的BM原因,仅次于肺癌。乳腺癌脑转移(BCBM)的发生率因分子亚型而异。一半的晚期人表皮生长因子受体2(HER2)阳性患者和三分之一的三阴性乳腺癌(TNBC)患者发展为BM。软脑膜转移(LM)的临床表现通常是非特异性的,可以表现为多种体征和症状,主要包括脑实质受累和脑膜刺激综合征颅神经受累,颅内压升高,和进行性脑功能障碍。因此,中国临床肿瘤学会(CSCO)乳腺癌委员会已经就BM制定了这一专家共识,努力改善BCBM的总体预后,促进本病的规范化诊断和治疗。在这一专家共识的发展过程中,我们进行了全面的文献综述,并参考了一些国内外最权威的指南。在这个共识中,我们将讨论临床表现,影像学检查,病理诊断,治疗,预后,跟踪和监测。我们希望这一共识将有助于所有主修乳腺癌和其他类似专业的临床医生。