Clinicopathologic Factors Associated with Survival in Patients with Breast Cancer Brain Metastasis

Publication date: Available online 17 April 2017
Source:Human Pathology
Author(s): Rong Li, Kui Zhang, Gene P. Siegal, Shi Wei
Brain metastasis from breast cancer generally represents a catastrophic event yet demonstrates substantial biological heterogeneity. There have been limited studies solely focusing on the prognosis of patients with such metastasis. In this study, we carried out a comprehensive analysis in 108 consecutive patients with breast cancer brain metastases between 1997 and 2012 to further define clinicopathologic factors associated with early onset of brain metastasis and survival outcomes after development of them. We found that lobular carcinoma, higher clinical stages at diagnosis, and lack of coexisting bone metastasis were significantly associated with a worse brain relapse-free survival when compared to brain only metastasis. High histologic grade, triple-negative breast cancer, and absence of visceral involvement were unfavorable prognostic factors after brain metastasis. Further, high histologic grade, advanced tumor stages and lack of coexisting bone involvement indicated a worse overall survival. Thus, the previously established prognostic factors in early-stage or advanced breast cancers may not entirely apply to patients with brain metastases. Further, the prognostic significance of the clinicopathologic factors differed before and after a patient develops brain metastasis. This knowledge might help in establishing an algorithm to further stratify breast cancer patients into prognostically significant categories for optimal prevention, screening and treatment of their brain metastasis.



http://ift.tt/2pNyBmc