Brain and leptomeningeal metastases are complications of breast cancer with high rates of morbidity and mortality and have an estimated incidence of up to 30%. While National Comprehensive Cancer Network (NCCN) guidelines recommend screening for central nervous system metastasis in other neurotropic cancers such as non-small cell lung cancer, there are no such recommendations for asymptomatic breast cancer patients at any stage of disease. This review highlights ongoing studies into screening and diagnostics for breast cancer with brain and leptomeningeal metastasis (BCBLM) as they relate to patient outcomes and prognostication. These include imaging methods such as MRI with novel contrast agents with or without PET/CT, as well as ‘liquid biopsy’ testing of the cerebrospinal fluid and serum to analyze circulating tumor cells, genomic material, proteins, and metabolites. Given recent advances in radiation, neurosurgery, and systemic treatments for BCBLM, screening for CNS involvement should be considered in patients with advanced breast cancer as it may impact treatment decisions and overall survival.
脑及软脑膜转移是乳腺癌的并发症，具有较高的发病率和死亡率，估计发生率可达30%。尽管美国国家综合癌症网络（NCCN）指南建议对其他嗜神经性癌症（如非小细胞肺癌）进行中枢神经系统转移筛查，但对于任何疾病阶段的无症状乳腺癌患者，目前尚无此类推荐。本综述重点探讨了针对乳腺癌脑及软脑膜转移（BCBLM）的筛查与诊断研究进展，这些研究与患者预后及疾病预测密切相关。相关方法包括影像学技术（如使用新型造影剂的MRI，联合或不联合PET/CT），以及通过脑脊液和血清进行“液体活检”，以分析循环肿瘤细胞、基因组物质、蛋白质和代谢物。鉴于近年来在BCBLM的放射治疗、神经外科手术及全身治疗方面取得的进展，对于晚期乳腺癌患者应考虑进行中枢神经系统受累筛查，因为这可能影响治疗决策和总体生存率。
肿瘤(癌症)患者之家