10 YEARS DISEASE-FREE SURVIVAL AFTER SOLITARY BRAIN METASTASIS FROM BREAST-CANCER

The unique case of a 51-year-old woman who developed a solitary brain metastasis as the first site of systemic disease 11 months after a tot al mastectomy for an undifferentiated infiltrating ductal carcinoma of her right breast is described. After surgery for the pT2pN0 carcinoma , the patient received radiotherapy of the internal mammary and suprac lavicular lymph nodes. The brain metastasis was treated with surgery a nd adjuvant whole-brain radiotherapy to a total dose of 30 Gy in Decem ber 1984 and January 1985, Afterwards a hormonal treatment with tamoxi fen was initiated, which still continues. Since then no further distan t or lymph node metastases have developed. The patient is under regula r after-care and undergoes various apparative examinations every 6 mon ths. She is generally well and suffers only from a postoperatively per sistent hemianopsia. This is the first case in which a disease-free su rvival for more than 10 years after brain metastases from breast cance r has been reported. It illustrates the specific biological behaviour of this tumour type and the chance of achieving long-term survival in very selected cases.