Introduction: The prognosis of the association between Breast Cancer (BC) and Meningioma (M) is still unknown. Our aim was to evaluate the survival impact of tumor exposure sequence in patients with both tumours.
Methods: Patients were divided in groups according to the tumors sequence: BC before M (group 1), synchronous BC+M (group 2) and BC after M (group 3). The SEER database was used. Demographics, meningioma and breast cancer variables were analyzed. The primary outcome was oncological survival.
Results: A total of 1715 patients were followed with a median follow-up of 84 months. Group 2 had the shortest survival (median: 32 months) and group 1 the longest (median: 110 months). Group 3 was the reference group. On the unadjusted analysis group 2 had the shortest survival (HR 3.13, 95%CI: 1.62-6.04) - Figure 1 - and adjusted analysis confirmed the previous finding (HR 3.11, 95%CI: 1.58-6.19), with no statistical difference between the metachronous tumors groups. Increasing age (HR:1.13, 95%CI:1.11-1.15, p<0.005) and grade III meningioma (HR:4.51, 95%CI:1.90-10.69, p<0.005) were related with lower survival. Meningioma treatment had no influence on the survival (p>0.05). The association between surgery and radiotherapy in BC treatment improved the outcome (HR: 0.37, 95%CI: 0.23-0.93, p<0.05). Grade III meningioma and receptor hormonal status influenced synchronous tumors (p<0.05) but had no influence on metachronous tumors survival (p>0.05) on stratified analysis.
Conclusions: Synchronous tumors were associated with lower survival, when compared with metachronous. Increasing age had a negative influence on patient survival. Eventhough surgery and radiotherapy for breast cancer had a positive influence in the outcome, meningioma treatment was not related with survival. Grade III meningioma and hormonal receptor status only influenced synchronous tumors patient survival.
Patient Care: The recognition of different histological patterns as well as different therapeutic approaches may influence and tailor the approach to this subgroup of patients.
Learning Objectives: By the conclusion of this session, participants should be able to recognize meningioma and breast cancer may have particular biological features and have a different therapeutic approach by the physicians when they occur together. When consider together, these may explain the worst prognosis.