Risk factors and survival outcomes in patients with brain metastases from breast cancer

Minisini, Alessandro Marco; Moroso, S.; Gerratana, Lorenzo; Giangreco, Manuela; Iacono, Donatella; Poletto, Elena; Guardascione, Michela; Fontanella, Caterina; Fasola, Gianpiero; Puglisi, Fabio

doi:10.1007/s10585-013-9594-5

Cited by 36 publications

(42 citation statements)

References 25 publications

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“…The median age at breast cancer diagnosis in our cohort was 51.65 years. We observed a higher incidence of HER2 overexpression with 45% of cases being positive for HER2 compared with the 20% incidence of HER2 positivity seen in all patients with breast cancer, this is in agreement with previous reports which have analyzed HER2 as a risk factor for the development of BM [18,19]. In a similar way, we also observed a lower incidence of luminal A tumors with only 25% of cases, and a 30% incidence of triple-negative disease.…”

Section: Discussionsupporting

confidence: 92%

Prognostic factors and survival of patients with brain metastasis from breast cancer who underwent craniotomy

2015

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Brain metastasis (BM) in patients with breast cancer is a catastrophic event that results in poor prognosis. Identification of prognostic factors associated with breast cancer brain metastases (BCBM) could help to identify patients at risk. The aim of this study was to assess clinical characteristics, prognostic factors, and survival of patients with BCBM who had craniotomy and resection in a series of patients treated with modern multimodality therapy. We analyzed 42 patients with BCBM who underwent resection. Patients were diagnosed with breast cancer between April 1994 and May 2010. Cox proportional hazards regression was selected to describe factors associated with time to BM, survival from the date of first recurrence, and overall survival (OS). Median age was 51 years (range 24-74). Median follow-up was 4.2 years (range 0.6-18.5). The proportion of the biological subtypes of breast cancer was ER+/HER2À 25%, ER+/HER2+ 15%, ER-/ HER2+ 30%, and ER-/HER2À 30%. Median OS from the date of primary diagnosis was 5.74 years. Median survival after diagnosis of BM was 1.33 years. In multivariate Cox regression analyses, stage was the only factor associated with shorter time to the development of BM (P = 0.033), whereas age was the only factor associated with survival from the date of recurrence (P = 0.027) and with OS (P = 0.037). Stage at primary diagnosis correlated with shorter time to the development of BM, while age at diagnosis was associated with shorter survival in BCBM. None of the other clinical factors had influence on survival.

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Section: Discussionsupporting

confidence: 92%

Prognostic factors and survival of patients with brain metastasis from breast cancer who underwent craniotomy

2015

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“…Most breast cancer studies have focused on the prognostic factors of survival from diagnosis or metastasis time to death (Yamasaki et al, 1992;Selzner et al, 2000;Nieder et al, 2008;Morris et al, 2012;Minisini et al, 2013). Risk factors of metastasis are routinely determined by using log-rank test or stratified analysis and survival analysis is used for modeling the overall survivorship.…”

Section: Exploring Factors Related To Metastasis Free Survival In Brementioning

confidence: 99%

Exploring Factors Related to Metastasis Free Survival in Breast Cancer Patients Using Bayesian Cure Models

Jafari‐Koshki

Mansourian²,

Mokarian³

2014

Asian Pacific Journal of Cancer Prevention

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Background: Breast cancer is a fatal disease and the most frequently diagnosed cancer in women with an increasing pattern worldwide. The burden is mostly attributed to metastatic cancers that occur in one-third of patients and the treatments are palliative. It is of great interest to determine factors affecting time from cancer diagnosis to secondary metastasis. Materials and Methods: Cure rate models assume a Poisson distribution for the number of unobservable metastatic-component cells that are completely deleted from the non-metastasis patient body but some may remain and result in metastasis. Time to metastasis is defined as a function of the number of these cells and the time for each cell to develop a detectable sign of metastasis. Covariates are introduced to the model via the rate of metastatic-component cells. We used non-mixture cure rate models with Weibull and log-logistic distributions in a Bayesian setting to assess the relationship between metastasis free survival and covariates. Results: The median of metastasis free survival was 76.9 months. Various models showed that from covariates in the study, lymph node involvement ratio and being progesterone receptor positive were significant, with an adverse and a beneficial effect on metastasis free survival, respectively. The estimated fraction of patients cured from metastasis was almost 48%. The Weibull model had a slightly better performance than log-logistic. Conclusions: Cure rate models are popular in survival studies and outperform other models under certain conditions. We explored the prognostic factors of metastatic breast cancer from a different viewpoint. In this study, metastasis sites were analyzed all together. Conducting similar studies in a larger sample of cancer patients as well as evaluating the prognostic value of covariates in metastasis to each site separately are recommended.

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“…Symptoms of increased cranial pressure and brain edema are treated most frequently with steroids. However, steroids can cause various serious side effects that further impair quality of life [3][4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

Alleviation of Brain Edema and Restoration of Functional Independence by Bevacizumab in Brain-Metastatic Breast Cancer: A Case Report

et al. 2014

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Background: Brain metastases (BM) are an increasing challenge in modern oncology, as treatment options especially after exhaustion of local treatment approaches are very limited. Patient and Methods: A long-term surviving patient with brain-only metastatic breast cancer, who presented at our department with massive corticosteroid-refractory brain edema with serious neurological symptoms after exhaustion of all local therapy options, was started on bevacizumab. Results: Initiation of bevacizumab monotherapy led to rapid decrease of contrast-enhancing lesions and alleviation of brain edema, and allowed tapering and termination of corticosteroid administration. Neurological and neurocognitive function was restored and marked improvement in quality of life was observed. Conclusion: Our case highlights that bevacizumab may represent a feasible and effective salvage treatment option in selected patients with BM.

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Risk factors and survival outcomes in patients with brain metastases from breast cancer

Cited by 36 publications

References 25 publications

Prognostic factors and survival of patients with brain metastasis from breast cancer who underwent craniotomy

Prognostic factors and survival of patients with brain metastasis from breast cancer who underwent craniotomy

Exploring Factors Related to Metastasis Free Survival in Breast Cancer Patients Using Bayesian Cure Models

Alleviation of Brain Edema and Restoration of Functional Independence by Bevacizumab in Brain-Metastatic Breast Cancer: A Case Report

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