Resection of breast cancer brain metastases: A single institution experience.

Abstract

e11569 Background: Resection of a single brain metastasis (SBM) in metastatic cancer has been shown to improve overall survival (OS). A previously reported series from MD Anderson of breast cancer patients undergoing SBM resection reported a median overall survival of 19 months. We report our experience of SBM resection for breast cancer. Methods: Retrospective observational study of patients who underwent resection of SBM from breast cancer brain in a tertiary referral centre from 2000-2011. Results: 20 patients underwent SBM resection from 2000-2011. All patients received WBRT after surgery. 2 patients had progressive metastatic disease presenting as brain metastases. Median time from original breast cancer diagnosis to development of SBM was 53 months (range:1-286months). 9 patients had solitary brain metastases (no metastases elsewhere) and 11 patients had synchronous metastases elsewhere. Regarding the primary breast tumour: 41% of patients were ER+, 57% were HER2+ and 25% were triple negative. 1 patient had discordance of ER status between the primary tumour and brain metastasis (changed from ER- to ER+). Median overall survival was 9 months (95% CI: 5-18 months) with 1 year OS of 50%, 2 year OS of 15% and 3 year OS of 5%. Patients treated between 2006-2011 had better median OS than those treated 2000-2005(18 months vs 6 months – p-value not significant). Patients with a solitary brain metastasis had better median OS than those with synchronous extracranial disease (13 months vs 6 months – p-value not significant). An additional 2 patients underwent craniotomy for presumed breast cancer metastasis but histology revealed glioblastoma multiforme. Conclusions: We report on a cohort of patients undergoing metastatectomy for single brain metastasis from breast cancer. Median OS was 9 months but there was a trend towards better survival in patients treated in recent years when compared with those treated from 2000-2005. Improved systemic therapies may account for this difference. Also of note 2 patients undergoing resection for presumed brain metastases were found to have GBM, highlighting the role of tissue diagnosis in patients presenting with a solitary brain lesion.