TITLE:
Clinicopathological Evaluation and Prognostic Analysis in Breast Cancer Patients with Brain Metastasis
AUTHORS:
Naoko Minatani, Hirokazu Tanino, Yoshimasa Kosaka, Mariko Kikuchi, Hiroshi Nishimiya, Mina Waraya, Hiroshi Katoh, Takumo Enomoto, Norihiko Sengoku, Masahiko Watanabe
KEYWORDS:
Brain Metastasis, Breast Cancer, Performance Status
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.8,
August
10,
2015
ABSTRACT: Background: Brain metastases
are diagnosed in 5% - 15% of patients with breast cancer. Clinical management of
brain metastases appears to be crucial in improving the prognosis of patients with
breast cancer that has metastasized to the brain. However, few studies have investigated
whether treatment of metastatic brain tumors would lead to improved prognosis. Methods:
A total of 41 breast cancer patients whose tumors metastasized to the brain and
who were diagnosed and treated at our hospital were enrolled. This study was conducted
to determine the characteristics of brain metastases and to identify the factors
that may affect the treatment and prognosis of patients with brain metastases. Results:
There were more patients with HER2 and triple negative subtypes than of the luminal
subtype. The median time from the initiation of breast cancer treatment to the onset
of brain metastasis was 31 months (range, 7 - 134 months). Significantly greater
disease-specific survival (DSS) was observed in patients who had a performance status
of 0 - 2 at the time of diagnosis of metastatic brain tumors than those with a performance
status of 3 - 4 (p = 0.04). DSS was also
significantly greater in patients who underwent surgery to remove brain metastases
and in patients treated with systemic therapy (p = 0.0007 and 0.0001, respectively). Conclusions: It may be possible
to improve the prognosis of patients with brain metastases if lesions are detected
early enough when the patients’ performance status is still good. In order for these
findings to be definitive, however, results of future prospective studies are eagerly
awaited.