Prolonged survival in carcinomatous meningitis associated with breast cancer

We describe a patient who survived for more than 7 years after the diagnosis of meningeal carcinomatosis associated with breast cancer. Meningeal carcinomatosis occurs in 1% to 5% of patients with breast cancer. The median survival ranges from 3 to 7 months, but most reports include a small number of patients who survive considerably longer, with up to 11% surviving more than 1 year. Early diagnosis, aggressive treatment of neurologic involvement, limited systemic tumor burden, and varied rates of progression are factors that may relate to extended duration of survival in these patients with breast cancer. Our patient, with a hormonally responsive adenocarcinoma of the breast and without systemic metastases, illustrates that meningeal carcinomatosis, like other forms of breast cancer metastasis, can run an indolent course. In such patients the delayed sequelae of therapy for metastasis to the central nervous system can profoundly influence the course of the illness.