Clinical outcome of patients with brain metastases from breast cancer - A population based study over 21 years.
Blood brain barrier
Brain metastases
Breast cancer
Incidence
Survival
Journal
Breast (Edinburgh, Scotland)
ISSN: 1532-3080
Titre abrégé: Breast
Pays: Netherlands
ID NLM: 9213011
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
06
05
2019
revised:
14
01
2020
accepted:
10
02
2020
pubmed:
8
3
2020
medline:
15
12
2020
entrez:
8
3
2020
Statut:
ppublish
Résumé
Brain metastases (BM) are a feared progression of breast cancer (BC) with impact on quality of life and survival. Despite improved treatments, it is believed patients suffering from BM are increasing. To study potential changes in the number of BM, the possible links between BC subgroup and extent of BM with prognosis. To investigate the interval between primary BC/extra cranial recurrence, and diagnosis of BM in the years 1994-2014. Clinical data from 191 patients with BM diagnosed 1994-2014, was retrieved from charts. Primary tumours where re-evaluated histologically. There was an increase of BM in 5 years cohorts (1994-99 (n = 9); 2000-04 (n = 36); 2005-09 (n = 60); 2010-14 (n = 86)). We found no difference in the time interval from primary BC to BM but an insignificant increase in time from extra cranial relapse to development of BM in the time periods 1994-2004 and 2005-2014 of 15.5 and 25.0 months (p = 0.0612). Survival after BM was 7 months (95% CI 6-10) with a statistically significant difference between HER2 positive and TNBC with an inferior outcome for the latter (p = 0.018) whilst no differences were present when Luminal BC were compared with HER2 positive BC (p = 0.073). We show an increase of BM over time whilst the time span from primary BC to BM is unchanged supports earlier findings that adjuvant treatments have little preventive function. Time from extra cranial recurrence to BM was prolonged with one year. Patients with TNBC or more advance extent of BM had the shortest survival with BM.
Sections du résumé
BACKGROUND
BACKGROUND
Brain metastases (BM) are a feared progression of breast cancer (BC) with impact on quality of life and survival. Despite improved treatments, it is believed patients suffering from BM are increasing.
AIMS
OBJECTIVE
To study potential changes in the number of BM, the possible links between BC subgroup and extent of BM with prognosis. To investigate the interval between primary BC/extra cranial recurrence, and diagnosis of BM in the years 1994-2014.
PATIENTS AND METHODS
METHODS
Clinical data from 191 patients with BM diagnosed 1994-2014, was retrieved from charts. Primary tumours where re-evaluated histologically.
RESULTS
RESULTS
There was an increase of BM in 5 years cohorts (1994-99 (n = 9); 2000-04 (n = 36); 2005-09 (n = 60); 2010-14 (n = 86)). We found no difference in the time interval from primary BC to BM but an insignificant increase in time from extra cranial relapse to development of BM in the time periods 1994-2004 and 2005-2014 of 15.5 and 25.0 months (p = 0.0612). Survival after BM was 7 months (95% CI 6-10) with a statistically significant difference between HER2 positive and TNBC with an inferior outcome for the latter (p = 0.018) whilst no differences were present when Luminal BC were compared with HER2 positive BC (p = 0.073).
CONCLUSIONS
CONCLUSIONS
We show an increase of BM over time whilst the time span from primary BC to BM is unchanged supports earlier findings that adjuvant treatments have little preventive function. Time from extra cranial recurrence to BM was prolonged with one year. Patients with TNBC or more advance extent of BM had the shortest survival with BM.
Identifiants
pubmed: 32145571
pii: S0960-9776(20)30064-3
doi: 10.1016/j.breast.2020.02.007
pmc: PMC7375610
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
113-124Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare no existing conflicts of interest.
Références
Neuro Oncol. 2017 Oct 19;19(11):1511-1521
pubmed: 28444227
Lancet. 2007 Feb 17;369(9561):559-70
pubmed: 17307102
Breast Cancer Res Treat. 2014 Aug;147(1):103-12
pubmed: 25106661
Breast. 2017 Dec;36:89-95
pubmed: 28988610
Lancet Oncol. 2011 Mar;12(3):236-44
pubmed: 21354370
Cancer. 1983 Dec 15;52(12):2349-54
pubmed: 6640506
Am J Clin Pathol. 1980 Feb;73(2):232-4
pubmed: 6243853
J Clin Oncol. 2010 Jul 10;28(20):3271-7
pubmed: 20498394
Clin Cancer Res. 2011 Jul 15;17(14):4834-43
pubmed: 21768129
J Clin Oncol. 2004 Jul 15;22(14):2865-72
pubmed: 15254054
Med Oncol. 2015 Jan;32(1):400
pubmed: 25433950
J Clin Oncol. 2007 Feb 10;25(5):486-92
pubmed: 17200148
Neurol Clin. 2003 Feb;21(1):1-23, vii
pubmed: 12690643
Med Oncol. 2013 Mar;30(1):408
pubmed: 23322521
Br J Cancer. 2009 Dec 1;101(11):1919-24
pubmed: 19826419
J Neurooncol. 2016 May;127(3):407-14
pubmed: 26909695
Ann Oncol. 2008 Nov;19(11):1837-41
pubmed: 18562328
Cancer. 2002 May 15;94(10):2698-705
pubmed: 12173339
Ann Oncol. 2013 Jun;24(6):1526-33
pubmed: 23463626
J Natl Cancer Inst. 2008 Jun 4;100(11):805-14
pubmed: 18505968
Lancet. 2017 Mar 25;389(10075):1195-1205
pubmed: 28215665
J Clin Oncol. 2014 Nov 20;32(33):3744-52
pubmed: 25332249
CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
pubmed: 21296855
J Clin Oncol. 2006 Dec 20;24(36):5664-71
pubmed: 17116941
Lancet Oncol. 2008 Jan;9(1):45-53
pubmed: 18083636
Br J Cancer. 2012 May 22;106(11):1850-3
pubmed: 22531629
BMC Cancer. 2018 Apr 19;18(1):446
pubmed: 29673325
NeuroRx. 2005 Jan;2(1):3-14
pubmed: 15717053
Ann Oncol. 2010 Nov;21(11):2183-2187
pubmed: 20430906
Breast Dis. 2016;36(4):133-141
pubmed: 27802190
Eur J Cancer. 2018 Oct;102:1-9
pubmed: 30099223
Ecancermedicalscience. 2013 Apr 18;7:307
pubmed: 23662165
Crit Rev Oncol Hematol. 2018 Jun;126:13-18
pubmed: 29759555
Br J Cancer. 2012 Jan 31;106(3):440-6
pubmed: 22233926
Oncol Lett. 2018 May;15(5):7090-7096
pubmed: 29725432
Arkh Patol. 2013 Mar-Apr;75(2):53-63
pubmed: 24006766
N Engl J Med. 2018 Aug 23;379(8):753-763
pubmed: 30110579
Cancer. 1979 Nov;44(5):1913-8
pubmed: 498057