Characteristics of patients with short and long survivals after detection of intracranial metastases from breast cancer

Abstract

The clinical course of 106 patients with brain metastases from breast cancer was retrospectively studied. Median time of survival after detection of intracranial metastases (SAR(ICM] was 14 weeks (95% confidence limits: 10-19 weeks), and 25% of the patients survived for more than 37 weeks, while only 17% survived for one year. The occurrence of clinical, pathoanatomical and therapeutical variables in these patients were analyzed in a subgroup of 57 patients, who survived for less than 16 weeks, and compared with a subgroup of 49 patients, who survived for more than 16 weeks after detection brain metastases. None of the variables studied were associated with either of the two prognostic groups. Patients with short SAR(ICM) had, however, a greater number of extra-cranial metastases at recurrence in the brain compared to patients with SAR(ICM) more than 16 weeks (p = 0.07). Patients with SAR(ICM) less than 16 weeks had a somewhat shorter recurrence-free interval (p = 0.22) and a significantly shorter time from primary diagnosis until detection of brain metastases (p = 0.04). Probably as a consequence of this, these patients had a shorter survival from primary diagnosis as well as from first recurrence. The findings may indicate that the differences in survival of patients with brain metastases are mainly due to differences in the rate of disease progression.

Role of surgery in the treatment of brain metastases in patients with breast cancer

“…The median age of 50 years in our patient population is consistent with previous studies of patients with breast cancer with brain metastases, in which the median age was 51 years (1,13). In addition, the high proportion of brain metastases presenting as the first site of distant disease, 29% in our study, is consistent with data reported in the literature (13,15,33). Paterson et al suggested that this unusually high rate of brain metastasis as the initial site of distant disease is related to the aggressive systemic therapy initiated at the time of the primary diagnosis (33).…”

“…The majority of the literature regarding RT describes the use of WBRT. Data regarding the use of WBRT consistently shows a median survival range for patients with breast cancer with brain metastases to be 12 to 16 weeks (1,6,12,15,16). Regarding stereotactic radiosurgery, there are currently no significant data with regard to its success in managing brain metastases in patients with breast cancer (7).…”

Central nervous system metastases from breast carcinoma: a clinical and laboratorial study in 47 patients

“…These results are similar to most of the published data and confirm that in breast cancer patients with signs and symptoms of neurological disease the diagnostic approach should associate neuroimaging with CSF examination 3,12,18 . The introduction of CEA and CA-15.3 analysis in the CSF work-up showed promising results, particularly as a diagnostic aid in leptomeningeal neoplasms.…”

“…Recent epidemiological data indicate that the incidence of CNS metastasis has been increasing in the last two decades; this could be explained by the increased survival of the breast cancer patients nowadays 3,4 . The clinical presentation of these patients is pleomorphic, depending on the localization of the lesions, meningeal involvement and paraneoplastic syndromes, as well as on therapeutic complications 2,5 .…”

Stereotactic Radiosurgery for Brain Metastases From Breast Cancer

“…Whole brain radiation alone has been reported to be associated with a 3-to 4-month survival in these patients. 1,[11][12][13][14] Chemotherapy is not widely used to treat metastases to the brain. A small number of available reports, however, cite an approximate 7-to 8-month survival in this population.…”