Clinical outcome of patients with brain metastases from breast cancer - A population based study over 21 years

Abstract

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: 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: Clinical data from 191 patients with BM diagnosed 1994–2014, was retrieved from charts. Primary tumours where re-evaluated histologically. 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: 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.

Keywords

• Breast cancer
• Brain metastases
• Incidence
• Survival
• Blood brain barrier