Breast cancer brain metastases: Molecular subtype, treatment and survival

Jennifer A. Crozier, Lauren F. Cornell, Bhupendra Rawal, Edith A. Perez

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

BACKGROUND: No clear guidelines exist for management of breast cancer brain metastases (BCBM). OBJECTIVE: We assessed the relationship between patient and tumor characteristics, treatment, and overall survival (OS). METHODS:We conducted a retrospective review of 196 patients who received brain radiation for BCBMbetween 2009-2013 at Mayo Clinic. Primary tumor characteristics were collected, including simplified molecular subtype. Other characteristics included patient's ECOG, number of brain lesions at BCBM diagnosis, and treatment received, including neurosurgery, whole-brain radiation therapy (WBRT), and stereotactic radiosurgery (SRS). The primary endpoint was OS from time of BCBM diagnosis. RESULTS: Single-variable analysis revealed patients with HER2+ breast cancer had improved OS (HR = 0:6, p = 0:008). Compared to patients with 1-3 brain lesions, the risk of death in patients with leptomeningeal disease was 2.5-fold higher (p = 0:003). Worsening ECOG status was associated with worsening OS. Patients who received SRS and WBRT had improved OS (HR = 0:37, p < 0:001) compared to patients receiving WBRT alone. CONCLUSIONS: Patients with the best OS had an ECOG of 0, HER2+ disease, and 1-3 brain lesions. The best OS was associated with the combination of neurosurgery and radiation therapy. A comprehensive treatment plan including neurosurgical evaluation and radiation therapy should be considered for patients with BCBM.

Original languageEnglish (US)
Pages (from-to)133-141
Number of pages9
JournalBreast Disease
Volume36
Issue number4
DOIs
StatePublished - 2016

Keywords

  • brain metastases
  • Breast cancer
  • radiation
  • survival
  • treatment

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

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  • Cite this

    Crozier, J. A., Cornell, L. F., Rawal, B., & Perez, E. A. (2016). Breast cancer brain metastases: Molecular subtype, treatment and survival. Breast Disease, 36(4), 133-141. https://doi.org/10.3233/BD-160237