Prognosis in Young Women less than 40 Years of Age with Brain Metastasis from Breast Cancer

Abstract

Background Brain metastasis from breast cancer (bca) in young women is doubly devastating because both quality of life and life expectancy are significantly reduced. With new radiation technology and drugs that have emerged, survival is expected to increase for these young women.Methods Using the oacis and sardo patient databases, we identified 121 patients diagnosed with bca and brain metastasis between 2006 and 2016 at the University of Montreal Hospital Centre. Those patients were divided into Group A, patients who developed brain metastasis during the evolution of metastatic bca, and Group B, patients whose first metastasis was to the brain. For each group, we compared young patients (<40 years of age) with older patients (≥40 years of age).Results Among the 121 patients with brain metastasis, median overall survival (mos) was significantly longer for those less than 40 years of age than for those 40 or more years of age (18 months vs. 4 months, p < 0.001). With respect to the timing of brain metastasis, survival was significantly longer in Group B than in Group A (7 months vs. 4 months, p = 0.032). In Group A, mos was significantly longer for patients less than 40 years of age than for patients 40 or more years of age (18 months vs. 3 months, p = 0.0089). In Group B, the 2-year overall survival rate was 57% for patients less than 40 years of age and 12% for those 40 or more years of age (mos: not reached vs. 7 months; p = 0.259).Conclusions In our single-centre retrospective cohort of women with brain metastasis from bca, prognosis was better for young women (<40 years) than for older women (≥40 years). Survival was also longer for patients whose initial metastasis was to the brain than for patients whose brain metastasis developed later in the disease course. In patients who received systemic treatment, median survival remained significantly higher in women less than 40 years of age. Further studies are needed to validate those results.

The Impact of Postoperative Tumor Burden on Patients With Brain Metastases

“…Age, time of surgery, and the prognostic value of age in terms of survival have been the subject of research with different statements as the aim of research varied or only single cancer entities were analyzed ( 3 , 24 – 26 ). Nevertheless, two messages can be stated, which are also significantly reflected by our results: First, younger age at time of surgery is correlated with a favored survival ( 26 ), and second, in an older population ( 3 ), tumor remnant in early postoperative MRI is the only risk factor for local in-brain recurrence. With a median age of 64.0 years (range 18–93) of the analyzed population, maximally selected log rank statistics revealed a significant cutoff for the age of 67 years ( p < 0.001), whereby 439/704 (62.4%) patients are ≤67 years.…”

Age Under 30 Years As a Predictor of Poor Survival in a Cohort of Mexican Women With Breast Cancer

“…In contrast, Mustillo et al emphasize that survival was higher in women <40 years with initial brain metastasis. 26 However, it must be remembered that metastasis is an important predictor of severe and poor survival, but prognosis will be determined by metastatic pattern and molecular subtype.…”

Clinical and Pathological Characteristics of Young Female Breast Cancer

“…We also reviewed study which reported that HER2 did not have an prognostic in uence on HR-positive young BC [27]. Age has been de ned as an independent risk factor for survival in BC patients [9,28,29]. Xu et al reported a 95.2% 5-year OS in patients under age 60 (mainly composed of post-menopausal women ) [30].…”