Analysis of the Meningiomas’ Hormonal Profile in Patients with Meningioma and Breast Cancer

Introduction: Meningioma is the most frequent primary tumor in the central nervous system (CNS), representing 33.8% of all intracranial tumors. Breast cancer (BC) is the most frequent cancer among women, representing 25.2% of all malignancies in females.

Since Schoenberg described in 1975 an increased incidence of meningiomas among patients diagnosed with BC, the postulated association between these tumors in women has been increasingly described over the past decades.

Even though there are some articles suggesting an association between meningiomas and breast cancer, the medical literature lacks an analysis and evaluation of the hormone receptors profile in both tumors among patients who developed both pathologies.

Objectives: To evaluate the meningioma`s hormone receptor expression in patients who presented synchronous or metachronous meningioma and breast cancer and compare its profile to the non-breast cancer associated meningiomas described in the literature.

Materials and Methods: The authors conducted a retrospective descriptive study evaluating all cases of synchronous and metachronous meningiomas and breast cancer from January 1, 1990, to December 31, 2020. The study was approved by the Ethics Review Board. Variables related to meningioma (age and year of diagnosis, histological grade and subtype, topography, the presence of progesterone, and/or estrogen receptors) and to breast cancer (age and year of diagnosis, the histological grade and subtype, the presence of progesterone and/or estrogen receptors) were collected.

Results: A total of 12 cases were included in the study, being 10 (83%) metachronous. The mean age at meningioma diagnosis was 60.58 (+10.99). The most frequent intracranial topography was convexity and sphenoid wing meningiomas (25% each). Ten patients (83%) had grade 1 meningiomas and 2 patients (16.6%) presented with grade 2 meningiomas. Eleven cases (91.67%) of meningiomas expressed progesterone receptors (PR) while 3 (25%) cases expressed estrogen receptors (ER).

Discussion: The higher incidence of meningiomas among women with previous breast cancer seems to be a fact, since recent articles identified a 26% higher meningioma incidence in this population. The sample analyzed in this study reinforced previous literature reports that metachronous cases are more frequent than synchronous cases, and that usually the diagnosis of BC is made before the diagnosis of meningioma.

Even though there is a higher rate of meningioma in patients with previous BC, this higher risk is not related to the hormone receptor profile of the BC (positive ER/PR status of the BC tumor does not confer additional risk of subsequent meningioma when compared with negative ER/PR BC patients). Previous literature data described that 32% of meningiomas expressed PR and 7% ER; while the expression of PR and ER in the BC were, respectively, 43 and 53%. These findings are in agreement with the results of this sample, once PR was more frequent than ER in meningiomas, while ER was more frequent than PR in BC.

Conclusion: The WHO histological analysis and steroid receptors profile did not seem to be different in the meningiomas included in this sample when compared with the description of no breast cancer–associated meningiomas.

Die Autoren geben an, dass kein Interessenkonflikt besteht.

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Artikel online veröffentlicht:
01. Februar 2023