Predictive Factors and Survival Rate for Brain Metastasis from Breast Cancer

Jung Ah Lee; Jeoung Won Bae; Sang Uk Woo; Jae Bok Lee; Byum Whan Koo

doi:10.4048/jbc.2008.11.2.71

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Lee, Bae, Woo, Lee, and Koo: Predictive Factors and Survival Rate for Brain Metastasis from Breast Cancer

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2008; 11(2): 71-76.

Published online: 30 June 2008

DOI: https://doi.org/10.4048/jbc.2008.11.2.71

Predictive Factors and Survival Rate for Brain Metastasis from Breast Cancer

Jung Ah Lee, Jeoung Won Bae, Sang Uk Woo, Jae Bok Lee, Byum Whan Koo

Department of Surgery, Korea University College of Medicine, Seoul, Korea.

kujwbae@korea.ac.kr

Received 6 August 2007 Accepted 27 March 2008

Abstract

Purpose

The incidence of symptomatic brain metastases from breast cancerhas ranged from 10% to 16%. Brain metastases are traditionally viewed as a late complication of systemic disease, for which few effective treatment options exist. The aim of this study was to evaluate the factors that can predict brain metastases and to analyze the survival rate as compared with other systemic metastases.

Methods

Between February 1983 and October 2005, 119 patient who developed systemic metastasis during the follow up period after optimal surgical treatment at Korea University Hospital were included in this study. Twenty-nine of these 119 patients had complaints of symptoms and they were consequently diagnosed as having brain metastases.

Results

Estrogen receptor (-), progesterone receptor (-) and Her2 (-), and Triple negative were a significantly higher in the patients with brain metastases (p=0.04). The other clinicopathologic factors showed no difference between the patients with brain metastases and the patients without brain metastases. Lung metastases existed previously more often than the other systemic metastases (p=0.04). The overall survival of the patients with brain metastases was not significantly different from the patients with other systemic metastases. However, the disease specific survival of patients with brain metastases, as compared with other systemic metastases was poorer than that for patients with bone and lung metastases, respectively (p=0.01 and 0.03). A poor prognosis was shown for the cases with brain metastases within 1 yr after operation.

Conclusion

Clinician should give attention to the possibility of brain metastases for the breast cancer patients with triple negative findings or the patients who have developed lung metastases as this represents a symptom of central nervous system.

Keywords: Breast cancer, Brain metastases, Predictive factor, Survival

Figures and Tables

Fig 1

Overall survival and disease specific survival of breast cancer patients with brain metastases versus without brain metastases.

Fig 2

According to metastatic location, disease specific of breast cancer patients with systemic metastases.

Fig 3

Contributing factors of survival in breast cancer with brain metastases.

Table 1

Clinicopathologic features of breast cancer patients with brain metastases versus without brain metastases

MRM=modified radical mastectomy; BCT=breast conserving treatment; ER=estrogen receptor; PR=progesterone receptor.

Table 2

Adjuvant therapy and metastatic location in breast cancer patients with brain metastases versus without brain metastases

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