The factors that have an impact on the development of brain metastasis in the patients with breast cancer

Dayan, Adem; Koca, Doğan; Akman, Tülay; Öztop, İlhan; Ellıdokuz, Hülya; Yılmaz, Uğur

doi:10.4103/0973-1482.106531

Cited by 10 publications

(5 citation statements)

References 35 publications

(50 reference statements)

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“…Therefore, the present study included the clinical conditions of patients in the development of the model; and multivariate analysis results revealed that meningeal metastasis was an independent factor for patient prognosis. There were 69 (16.8%) cases of meningeal metastases among the patients enrolled in the present study, which was slightly more than the numbers reported in previous studies ( 37 , 38 ). This may be associated with the extended survival of patients, as well as the wide application of magnetic resonance imaging in the diagnosis of brain tumors.…”

Section: Discussioncontrasting

confidence: 59%

A nomogram for predicting survival in patients with breast cancer brain metastasis

Huang

Sun

et al. 2018

Oncol Lett

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Brain metastasis (BM) is common in patients with breast cancer. Predicting patient survival is critical for the clinical management of breast cancer brain metastasis (BCBM). The present study was designed to develop and evaluate a prognostic model for patients with newly diagnosed BCBM. Based on the clinical data of patients with BCBM treated in the Affiliated Hospital of Academy of Military Medical Sciences (Beijing, China) between 2002 and 2014, a nomogram was developed to predict survival using proportional hazards regression analysis. The model was validated internally by bootstrapping, and the concordance index (c-index) was calculated. A calibration curve and c-index were used to evaluate discriminatory and predictive ability, in order to compare the nomogram with widely used models, including recursive partitioning analysis (RPA), graded prognostic assessment (GPA) and breast-graded prognostic assessment (Breast-GPA). A total of 411 patients with BCBM were included in the development of this predictive model. The median overall survival time was 14.1 months. Statistically significant predictors for patient survival included biological subtype, Karnofsky performance score, leptomeningeal metastasis, extracranial metastasis, the number of brain metastases and disease-free survival. A nomogram for predicting 1- and 2-year overall survival rates was constructed, which exhibited good accuracy in predicting overall survival with a concordance index of 0.735. This model outperformed RPA, GPA and Breast-GPA, based on the comparisons of the c-indexes. The nomogram constructed based on a multiple factor analysis was able to more accurately predict the individual survival probability of patients with BCBM, compared with existing models.

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Section: Discussioncontrasting

confidence: 59%

A nomogram for predicting survival in patients with breast cancer brain metastasis

Huang

Sun

et al. 2018

Oncol Lett

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“…However, it is difficult for patients to survive longer than 7 months after diagnosis of BM [12]. Unlike other metastatic sites of cancers, BMs can make survival short due to decreased performance status of cancer patients [17]. These neurological sequelae make it hard to treat patients more comprehensively.…”

Section: Introductionmentioning

confidence: 99%

Demographic and Socioeconomic Factors for Renouncing Further Active Therapy for Patients with Brain Metastasis of Non-Small Cell Lung Cancer

Gyu-Seo

Kim

et al. 2019

Brain Tumor Res Treat

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BackgroundAs patients with brain metastasis (BM) of non-small cell lung cancer (NSCLC) have dismal prognosis, some of them decide to discontinue further treatment for BM. The objective of this study was to determine factors for renouncing further active therapy in patients with BM of NSCLC, focusing on their demographic and socioeconomic status.MethodsMedical records of 105 patients with radiological diagnosis of BM of NSCLC for the recent 11 years at authors' institution were retrospectively reviewed. Clinical features as well as demographic and socioeconomic characteristics such as marriage status, cohabiting family members, religious affiliations, educational background, and economic responsibility were reviewed.ResultsMedian overall survival (OS) was 13.84 (95% CI: 10.26–17.42) years in 67 patients (group A) who underwent active treatment (radiotherapy and/or chemotherapy) and 4.76 (95% CI: 3.12–6.41) years in 38 patients (group B) who renounced active treatment. Less patients were unmarried (p=0.046), more cohabitating family members (p=0.008), and economically independent (p=0.014) in group A than those in group B. Similarly, the unmarried, and none cohabitating family members had short OS (5.17 and 7.38 years, respectively). In multivariate analysis for predisposing factors of OS in these patients, the following demographic and socioeconomic factors had independent significance: marriage status and cohabitating family members.ConclusionThis study suggests that demographic and socioeconomic status as well as clinical factors could influence the decision of further active treatment and prognosis of patients with BM of NSCLC.

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“…Breast cancer (BC) is the second, after lung cancer (40–50%), most common cause of brain metastases (brain metastases from breast cancer – BMF-BC) (15–25%), and in this respect it comes before melanoma (5–15%) and renal and colorectal cancers [ 1 – 6 ]. At diagnosis of a BC of a locoregional extent, the risk of BMF-BC development is about 5% [ 4 , 7 – 9 ], but in patients with a generalized BC it reaches 7–17% [ 1 , 2 , 4 , 7 , 9 – 12 ], and in 1.3% of patients BMF-BC are the first symptom of a metastatic disease [ 7 , 9 ]. At autopsy, BMF-BC are found in about 30% of patients who died of BC, and in the group of patients with metastatic disease in 6 or more locations this percentage rises up to 86% [ 1 , 2 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…At diagnosis of a BC of a locoregional extent, the risk of BMF-BC development is about 5% [ 4 , 7 – 9 ], but in patients with a generalized BC it reaches 7–17% [ 1 , 2 , 4 , 7 , 9 – 12 ], and in 1.3% of patients BMF-BC are the first symptom of a metastatic disease [ 7 , 9 ]. At autopsy, BMF-BC are found in about 30% of patients who died of BC, and in the group of patients with metastatic disease in 6 or more locations this percentage rises up to 86% [ 1 , 2 , 4 ]. The incidence of BMF-BC is systematically increasing due to: increasing incidence of cancers related to population ageing, improved survival of BC patients associated with adjuvant treatment and better efficacy of systemic treatment of generalised BC, and also due to the progress in imaging technology (CT, MRI, PET) [ 1 , 3 , 5 , 10 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…BMF-BC usually develop in late, advanced stages of the neoplastic process and in general they are preceded by extracranial distant metastases, e.g. bone, liver or lung metastases [ 2 , 4 , 5 , 14 ]. Median time between BC diagnosis and BMF-BC occurrence is 2–3 years and varies significantly between different BC subtypes, as follows: 28, 36, 47 and 54 months for triple negative, HER2+, luminal B and luminal A disease, respectively [ 1 , 15 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Methods and results of local treatment of brain metastases in patients with breast cancer

Szadurska¹,

Pluta²,

Walasek³

et al. 2016

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This article presents methods and results of surgical treatment and radiation therapy of brain metastases in breast cancer patients (brain metastases from breast cancer BMF-BC). Based on the literature data, it was shown that patients with single BMF-BC, aged less than 65 years, with Karnofsky score (KPS) of 70 or more and with cured or controlled extracranial disease are the best candidates to surgical treatment. Irrespective of the extracranial disease control status, there are indications for surgery in patients with symptomatic mass effect (tumour diameter larger than 3 cm) and patients with obstructive hydrocephalus from their BMF-BC. Stereotactic radiosurgery (SRS) has some advantages over surgery, with similar effectiveness: it may be used in the treatment of lesions inaccessible to surgery, the number of lesion is not a limiting factor if each lesion is small (< 3) and adequate doses can be delivered, it is not contraindicated in patients with active extracranial disease, it does not interfere with ongoing systemic treatment, and it does not require general anaesthesia or hospitalisation. A disadvantage of SRS, as compared to whole brain radiotherapy (WBRT), in patients with BMF-BC is the possibility of subsequent development of new lesion in the non-irradiated field. Thus the majority of the BMF-BC patients are not good candidates to surgery or SRS; WBRT alone or combined with a systemic treatment still plays a major role in the treatment of these patients.

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The factors that have an impact on the development of brain metastasis in the patients with breast cancer

Abstract: As the prognostic and predictive factors showing the development of brain metastasis in breast cancer patients may be identified, follow-up also including the brain is important in order to take preventive measures.

Cited by 10 publications

References 35 publications

A nomogram for predicting survival in patients with breast cancer brain metastasis

A nomogram for predicting survival in patients with breast cancer brain metastasis

Demographic and Socioeconomic Factors for Renouncing Further Active Therapy for Patients with Brain Metastasis of Non-Small Cell Lung Cancer

Methods and results of local treatment of brain metastases in patients with breast cancer

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