Brain metastases (BM) occur in 15-30% of patients with metastatic breast cancer (MBC). In spite of improvements in the treatment, the development of BM is still being a major limitation of life expectancy and quality of life for many patients (P).
Ambispective analysis of MBC patients who developed single or multiple BM and were treated in a single cancer comprehensive center. Identification of patients and updates of follow up were performed through Radiation Oncology department registries and Pathology Records. Breast Graded Prognostic Assessment (GPA) was calculated according to Sperduto GPA (2012).
From 2007 to 2014, 133 patients were identified; 30(22.6%) were diagnosed at de novo IV stage. Median age at BM diagnosis 52.3 years (29.7-81); 53 (39.8%) were luminal (LT), 42 (31.6%) HER2 positive (Her2), 31 (23.3%) triple negative (TN) and 7 cases unknown. Median PFS was 28m and median time to BM after cancer diagnosis (TBM) was 41 m (71m in LT, 26m in Her-2 and 20 m in TN (p 3 lesions 8 m (5-11) and according subtypes LT 11 m (4-18),TN 8m (4.5-11.5) and Her2 26m (7-45). Local treatment with SRS and S prolonged BMS (28 vs 8 m p= 0.001) as well as the administration of chemotherapy (29 vs 10 m p = 0.032). Significant prognostic factors by multivariate Cox regression were GPA (HR 0.7 CI 0.55-0.91 p = 0.008) and number of lesions (HR 1.3 CI 1.03-1.79 p = 0.027).
Breast-GPA, number of lesions and type of treatment are the most important prognosis factors for MBC patients with BM. Multidisciplinary treatment should be decided according to these factors.
Clinical trial identification
Legal entity responsible for the study
Jenniffer Linares Aceituno
Catalan Institute of Oncology
All authors have declared no conflicts of interest.