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Purpose <p>Dural metastases represent an uncommon pattern of central nervous system (CNS) involvement in breast cancer and are often grouped together with other CNS metastatic sites despite their distinct clinical features. Data on isolated dural disease remain scarce. We aimed to characterize the clinical features and survival outcomes of breast cancer patients with dural-only CNS metastases.</p> Methods <p>Breast cancer patients with radiologically confirmed dural-only CNS metastases were retrospectively identified at a&#xa0;tertiary referral center. Overall survival (OS) was calculated from CNS metastasis diagnosis.</p> Results <p>Among 432 patients with CNS metastases, 46&#xa0;(10.6%) had dural-only involvement. Median OS was 9.6&#xa0;months (95% confidence interval [CI]: 3.8–15.3), with OS rates of 78.3%, 50.0%, and 21.7% at 3, 12, and 36&#xa0;months, respectively. Performance status was the strongest prognostic factor: Patients with ECOG 0–1 had longer median OS than those with ECOG ≥ 2 (25.7 vs. 3.9&#xa0;months; hazard ratio [HR]: 5.70, 95% CI: 2.67–12.20; <i>p</i> &lt; 0.001). Survival was longer in patients with dural-only CNS metastases at first metastatic presentation than after prior extracranial metastases (25.7 vs. 8.5&#xa0;months; HR: 2.78, 95% CI: 1.36–5.68; <i>p</i> = 0.005).</p> Conclusion <p>Dural-only metastases represent a&#xa0;distinct manifestation of breast cancer. Survival is primarily influenced by performance status and the timing of CNS involvement.</p>

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Dural-only metastases in breast cancer: clinical course, prognostic factors, and implications for central nervous system  management

  • 期刊论文

  • 发表日期：

    2026年7月7日

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  • Tuğba Önder,
  • Öztürk Ateş

摘要

Purpose

Dural metastases represent an uncommon pattern of central nervous system (CNS) involvement in breast cancer and are often grouped together with other CNS metastatic sites despite their distinct clinical features. Data on isolated dural disease remain scarce. We aimed to characterize the clinical features and survival outcomes of breast cancer patients with dural-only CNS metastases.

Methods

Breast cancer patients with radiologically confirmed dural-only CNS metastases were retrospectively identified at a tertiary referral center. Overall survival (OS) was calculated from CNS metastasis diagnosis.

Results

Among 432 patients with CNS metastases, 46 (10.6%) had dural-only involvement. Median OS was 9.6 months (95% confidence interval [CI]: 3.8–15.3), with OS rates of 78.3%, 50.0%, and 21.7% at 3, 12, and 36 months, respectively. Performance status was the strongest prognostic factor: Patients with ECOG 0–1 had longer median OS than those with ECOG ≥ 2 (25.7 vs. 3.9 months; hazard ratio [HR]: 5.70, 95% CI: 2.67–12.20; p < 0.001). Survival was longer in patients with dural-only CNS metastases at first metastatic presentation than after prior extracranial metastases (25.7 vs. 8.5 months; HR: 2.78, 95% CI: 1.36–5.68; p = 0.005).

Conclusion

Dural-only metastases represent a distinct manifestation of breast cancer. Survival is primarily influenced by performance status and the timing of CNS involvement.