Treatment outcomes and prognostic factors for patients with brain metastases from breast cancer of each subtype: a multicenter retrospective analysis

Abstract

To define prognostic factors for breast cancer patients with brain metastases, compare their clinical courses and prognoses according to breast cancer subtypes, and analyze the causes of death in such patients. We retrospectively analyzed 1,466 patients diagnosed with brain metastases between April 1, 2001 and December 31, 2012, from 24 institutions of the Japan Clinical Oncology Group. Overall, 1,256 patients with brain metastases were included. The median overall survival (OS) was 8.7 months (95 % confidence interval [CI] 7.8-9.6 months). Univariate and multivariate analyses revealed that patients diagnosed with brain metastasis within 6 months of metastatic breast cancer diagnoses, asymptomatic brain disease, or HER2-positive/estrogen receptor-positive tumors had increased OS. Median OS after the development of brain metastases was 9.3 months (95 % CI 7.2-11.3) for the luminal type, 16.5 months (95 % CI 11.9-21.1) for the luminal-HER2 type, 11.5 months (95 % CI 9.1-13.8) for the HER2 type, and 4.9 months (95 % CI 3.9-5.9) for the triple-negative type. Luminal-HER2 type patients had significantly longer OS than patients with the luminal type (hazard ratio [HR] = 1.50, P < 0.0001) and triple-negative type (HR = 1.97, P < 0.0001); no significant differences were noted compared to HER2-type patients (HR = 1.19, P = 0.117). The prognosis and clinical course of patients with brain metastasis from breast cancer before and after developing brain metastases vary according to subtype. Focusing on the subtypes of breast cancer can optimize the prevention, early detection, and improved treatment of brain metastases.

Retrospective Review for Prevalence and Survival in Metastatic Breast Cancer with Brain Metastasis in Two Patient Cohorts: One Collected 2000-2005 and the Second Collected 2006-2011

“…This is similar to previous findings reported by Niikura and colleagues [15]. However, our study found that TN patients did not have a significantly worse overall survival when compared to luminal A or HER2+ patients, as previously reported [15].…”

Nanoparticles coated with the tumor-penetrating peptide iRGD reduce experimental breast cancer metastasis in the brain

“…Of particular concern is the treatment of brain metastases in patients with triple-negative breast cancer. Retrospective analysis of triple-negative patient data has revealed a high incidence of brain metastasis with a short latency and shortest median overall survival after intracranial tumor development than in other subtypes of breast cancer [2, 3]. Consequently, there is an increasing interest in novel ways of detecting, preventing, and eventually treating triple-negative breast cancer brain metastases.…”

Brain Metastases in Breast Cancer

“…Breast cancer subtypes are known to affect the clinical course and prognosis of both primary breast cancer (28 -30) and MBC (31). It has been found that molecular subtype is a predictive factor for overall survival after the development of brain metastasis (32,33) Previous studies have shown that median survival is shortest among patients with triple-negative breast cancer, ranging from 3 to 4 months (10,32,34,35). Although patients with HER2-positive tumors have higher rates of brain metastases, median survival for these patients is longer than it is for patients with triple-negative and luminal tumor types (10,35,36).…”