Ghali, R., Gaballah, A., Saleh, E., Arif, A. (2018). Prognostic Factors in Breast Cancer Patients with Brain Metastases: Retrospective Analysis. Research in Oncology, 14(2), 64-69. doi: 10.21608/resoncol.2018.3356.1054
Ramy Ghali; Ahmed Gaballah; Essam Saleh; Aamer Arif. "Prognostic Factors in Breast Cancer Patients with Brain Metastases: Retrospective Analysis". Research in Oncology, 14, 2, 2018, 64-69. doi: 10.21608/resoncol.2018.3356.1054
Ghali, R., Gaballah, A., Saleh, E., Arif, A. (2018). 'Prognostic Factors in Breast Cancer Patients with Brain Metastases: Retrospective Analysis', Research in Oncology, 14(2), pp. 64-69. doi: 10.21608/resoncol.2018.3356.1054
Ghali, R., Gaballah, A., Saleh, E., Arif, A. Prognostic Factors in Breast Cancer Patients with Brain Metastases: Retrospective Analysis. Research in Oncology, 2018; 14(2): 64-69. doi: 10.21608/resoncol.2018.3356.1054
Prognostic Factors in Breast Cancer Patients with Brain Metastases: Retrospective Analysis
1Clinical Oncology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2Ramadi General Hospital, Anbar, Iraq
Abstract
Background: Breast cancer is first cause of cancer-related deaths and it is estimated that 15% of breast cancer patients will develop brain metastases (BM). Its incidence differs according to many factors like molecular subtypes and burden and duration of systemic disease. Triple negative disease is an aggressive subtype with lifetime BM incidence of 25-46%. Survival of patients with BM is generally poor and affected by molecular subtypes, patient's performance, number and burden of visceral metastasis and resectability of brain lesions. Aim: This analysis aimed at evaluating the prognostic factors in breast cancer patients with BM. Methods: We retrospectively reviewed breast cancer patients' files treated at a single institute between January 2010 and December 2014. From 2095 files reviewed, 32 had BM. The clinico-epidemiological, pathological, treatment received and survival data were extracted and analysed. Results: Median age at BM diagnosis was 49.5 years (range 27-69). Median time from breast cancer diagnosis to BM diagnosis was 16 months (95% CI: 13.23-18.77). Postmenopausal women represented 59% of patients and 56% of them had a good performance status (ECOG 1-2). The majority of patients had grade II disease and invasive ductal carcinoma (65.6% and 81.3%, respectively). The tumor subtype was hormone receptor positive/HER2-neu negative in 25%, triple negative in 25% and HER2-neu positive in 50%. More than 2/3 of patients presented with signs of increased intracranial tension. Seven (22%) patients had single BM lesion, 22 (69%) had multiple lesions and 3 (9%) had concomitant leptomeningeal metastases. Three (9%) patients underwent brain metastatectomy. The median progression free survival was 4.5 months (95% CI: 3.58-5.42) and was significantly longer among patients who underwent metastatectomy (p=0.023) and those with hormone receptor-positive disease (p=0.007). The median overall survival was 6.5 months (95% CI: 4.23-9.77) and was significantly longer in patients with better performance status (ECOG 1), hormone receptor-positive disease, low number of metastatic sites and brain metastatectomy (p=0.037, 0.045, Conclusion: Brain metastases in breast cancer patients is an indicator of short survival which is influenced by tumor subtype, performance status, burden of systemic disease and ability to perform metastatectomy.
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