Analysis of Prognostic Factors Affecting the Brain Metastases Free Survival and Survival After Brain Metastases in Breast Cancer

Abstract

This study aimed to analyze the factors affecting brain metastases free survival (BMFS) and the survival after brain metastases (SABM). The data of 215 patients with breast cancer brain metastases (BCBM) in Sun Yat-sen University Cancer Center from January 2000 to August 2017 were retrospectively analyzed. The clinicopathological features of BCBM were analyzed, and their effects on BMFS and SABM were analyzed by univariate and multivariate COX regression. Finally, it was analyzed whether the receptor status of the brain metastases and the primary lesions were consistent. The median age of the entire cohort was 46 years old. The median BMFS, SABM and overall survival were 31, 9 and 44.2 months, respectively. Clinical stage, molecular subtypes and bone metastasis were independent prognostic factors affecting BMFS. TNM stage IV (HR, 4.99 [95% CI, 2.13-11.7]) and triple negative subtype (HR, 2.06 [95% CI, 1.35-3.14]) was significantly associated with shorter BMFS, but the presence of bone metastases (HR, 0.63 [95% CI, 0.45-0.88]) was a favorable factor for BMFS. Molecular subtypes, resection of BCBM and whole brain radiotherapy (WBRT) were independent factors for SABM. The triple negative subtype (HR, 2.02[95% CI, 1.12-3.64]) was significantly associated with shorter SABM. However, resection of BCBM (HR, 0.31 [95% CI, 0.15-0.65]) and WBRT (HR, 0.57 [95% CI, 0.35-0.93]) were independent factors in improving SABM. The conversion rate of ER was 11.1%, PR was 29.6%, and HER2 was 3.7% between paired breast cancer and brain metastases. BMFS and SABM have different influencing factors. Resection of BCBM and WBRT can significantly improve SABM. The frequency of HER2 status changes between the paired BCBM and the primary lesions is low.

Determinants of the interval to brain metastasis from initial breast cancer diagnosis and its relation to survival: a single-center retrospective cohort

“…[12] Several factors have been associated with time interval to BM, among them tumor subtype is one of the most common. [7,13] In our cohort we found an onset time to BM comparable and within the range of other reported studies in the literature (28-54 months). [5,7] We found for the general group that the subtypes of receptors ER-/HER2 + and ER+/HER2 + were statistically signi cant and associated with a shorter time onset to BM.…”

“…HER2 + status has been associated with early BM in prior studies. [13][14][15][16][17] HER2 gene over-expression results in a tumor with more invasive properties, increased proliferation, and tumorigenic growth.…”

Incidence, risk factors and survival of patients with brain metastases at initial metastatic breast cancer diagnosis in China

“…Currently, robust studies focusing on brain metastases at initial MBC diagnosis in China are lacking. Small retrospective studies involving patients with BM at any period of metastatic setting have yielded varying results [7,8]. In this study, we aimed to characterize the incidence of BM at MBC diagnosis, using the China National Cancer Center database.…”

Identification and validation of glycolysis-related signatures for prognosis in patients with breast cancer

“…Generally, it has been recognized that cancers with local, regional, and metastatic cancers have a worsening prognosis. In breast cancer, the molecular subtypes significantly affect the occurrence and prognosis of patients with brain metastasis [35] . However, these clinical factors cannot fully predict the prognosis of cancers.…”