How do you treat leptomeningeal carcinomatosis in metastatic breast cancer?  

Do you consider placing an Ommaya for IT chemo with methotrexate or cytarabine? Knowing that leptomeningeal carcinomatosis carries such a poor prognosis, I discuss goals of care and comfort-oriented approaches such as hospice with my continuity patients, but we're asked to see patients for a second opinion regarding chemotherapy options.

Answer from: Medical Oncologist at Academic Institution