Prognostic factors for patients with newly diagnosed brain metastasis from breast cancer

Abstract

Factors associated with both initial tumor and clinical features at BM time are associated with shorter survival in our Latinas population.

Identification of risk factors for central nervous system metastasis in patients with breast cancer with neurologic symptoms

“…The majority of CNSm cases appear within 2 to 3 years of the initial BC diagnosis, with a mean of 34.6 months 3,7 ; the findings of the current study are consistent with these data (33 months). The MOS after the diagnosis of CNSm ranges widely from 4 to 9 months, 3,6,11 with 1‐year survival rates of 20% to 28%, 3,6,7 a finding that is similar to the results noted in the current study cohort (12 months and 21%, respectively). In a report by Sperduto et al that evaluated survival among patients with PM, 17 the MOS was 13.8 months, whereas in the current study, patients with PM had a MOS of 15.4 months.…”

“…BC is the most common solid tumor to result in NM in women, 5 which carries fatal outcomes within a short time frame (7 weeks) 16 . The majority of CNSm cases appear within 2 to 3 years of the initial BC diagnosis, with a mean of 34.6 months 3,7 ; the findings of the current study are consistent with these data (33 months). The MOS after the diagnosis of CNSm ranges widely from 4 to 9 months, 3,6,11 with 1‐year survival rates of 20% to 28%, 3,6,7 a finding that is similar to the results noted in the current study cohort (12 months and 21%, respectively).…”

“…Information from the Surveillance, Epidemiology, and End Results (SEER) database shows that the incidence of central nervous system metastasis (CNSm) is as high as 1%, 1 and the risk of developing CNSm ranges from 10% to 16% among patients living with BC and can reach 30% in autopsy series 2 . The risk of CNSm increases among patients who are of a young age at the time of diagnosis 3‐6 and have lymph node involvement, high tumor grade, 3,5‐7 human epidermal growth factor receptor 2 overexpression (HER2+), 3,5,8 estrogen receptor–negative (ER−) status, 5,7,9 and lung metastasis as the first site of disease recurrence 6 …”

Breast Cancer Brain Metastases: Clonal Evolution in Clinical Context

“…Our understanding of chemotherapy efficacy in different contexts is generally poor (particularly in relation to primary tumour histology and pre-treatment history), due to a lack of prospective clinical trials and drug uptake data. For example, depending on practice standards (which vary internationally and even between centres in the same country), chemotherapy is often given to patients with BM after local measures to control systemic disease, which apparently poses the most imminent health threat—multiple retrospective analyses have shown systemic disease burden is a poor prognostic indicator [ 5 , 6 , 7 ], and the presence of extracranial mets is a component of the Radiation Therapy Oncology Group’s (RTOG) Graded Prognostic Assessment (GPA) tool [ 8 , 9 ]. In breast cancer, extracranial disease is present in ~80% of patients with BM [ 10 , 11 ], but in contrast to earlier RTOG studies, recent meta-analyses found that extracranial disease is not prognostic after accounting for human epidermal growth factor receptor 2 (HER2) and hormone receptor status [ 3 ].…”

Radiographic markers of breast cancer brain metastases: relation to clinical characteristics and postoperative outcome

“…Individuals with triple negative BC and positive status of human epidermal growth factor receptor 2 (HER2) are prone to BM [ 35 , 38 , 51 ]. The overall survival (OS) after BM surgery depends on multiple factors like Karnofsky Performance Status (KPS) scale score, number of BM, presence of extracranial metastases, patients’ age, timing between BC and BM, histopathological parameters, and (neo-) adjuvant treatments [ 3 , 11 , 20 , 31 , 33 , 35 , 60 , 61 ]. In case of BCBM, the median OS varies between 7.2 and 37.7 months.…”