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Cognitive Impairment Secondary to Treatment of Cured Brain Metastases of Triple-Negative Breast Carcinoma

Elise F Nassif*, Alexandre Arsene-Henry, Youlia M Kirova

Department of Radiotherapy, Institut Curie, 26 rue d’Ulm, 75005 Paris, France

Corresponding author: Elise F Nassif, Department of Radiotherapy, Institut Curie, 26 rue d’Ulm, 75005 Paris, France 

Received: April 12, 2019
Published: May 2, 2019

ABSTRACT

Context: Brain metastases from triple-negative breast cancer (TNBC) are not curable and can be invalidating, rapidly progressive. This justifies aggressive treatments.

Materials and methods: We report the case of a 58 years old women cured of brain metastases from TNBC. Initial diagnosis was of locally advanced inflammatory TNBC for which the patient underwent high-dose neo-adjuvant chemotherapy followed by surgery, radiotherapy and adjuvant chemotherapy. Symptomatic brain metastases were diagnosed 10 months after the end of adjuvant chemotherapy. Whole-brain radiotherapy and stereotactic radiosurgery were rapidly delivered followed by twelve months of chemotherapy.

Results: The patient is still alive and disease-free twelve years after these aggressive treatment protocols. However, she is disabled from neurologic and cognitive toxicities from treatments. There is currently no available treatment of this cognitive deterioration. Preventive measures are scarce and some are under study with promising results. The multiplicity of neurotoxic treatments for patients with brain metastases should be avoided when possible. The benefit-risk balance should be closely evaluated.  

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