Artikel
Timing of breast cancer brain metastases – risk factors and relation to the characteristics of metastases and postoperative survival
Zeitintervall für das Auftreten von Hirnmetastasen bei Mammakarzinom: Einflussfaktoren und Zusammenhang mit Eigenschaften der Metastasen und postoperativer Überlebensprognose
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Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Breast cancer (BC) is the most frequently diagnosed primary tumor entity in women. The incidence of brain metastases (BM) varies, and different time intervals (TI) between initial BC diagnosis and BM were reported. The aim of our study was to identify the factors associated with TI of BC BM occurrence.
Methods: We included all female patients with BC who underwent BM surgery in our institution between 2008 and 2019. Various clinical, radiologic, and histopathologic markers were analyzed with respect to TI. Univariate and multivariate analyses were performed.
Results: A total of 95 patients (median age of 60.0 years) were included. The median TI was 41.0 months (range 0-334 months). Age ≥65 years at BC diagnosis (aOR=4.45, 95% CI= 1.28 – 15.49, p=0.019), adjuvant trastuzumab therapy (aOR=7.75, 95% CI= 2.04 – 29.41, p=0.003), and neoadjuvant chemotherapy (aOR=3.91, 95% CI= 1.36 – 11.26, p=0.011) for initial BC presented as independent predictors of BM occurring in the shorter TI (<4 years). We identified a significant association between the TI (<4 years) and positive HER2 receptor status in BM (aOR=3.12, 95% CI= 1.00 – 9.76, p=0.051), midline shift on MRI (aOR=6.30, 95% CI= 1.16 – 34.22, p=0.033), preoperative leukocytosis (aOR=3.71, 95% CI= 1.24 – 11.05, p=0.019), and identic receptor status in BC and BM (aOR=3.07, 95% CI= 1.04 – 9.08, p=0.043). A shorter TI (<5 years) showed an association with poorer 3-years outcome after BM surgery (aOR=1.72, 95% CI= 1.01 – 2.92, p=0.045).
Conclusion: Several factors seem to influence the period between BC and BM, and shorter TI is related to poorer postoperative survival. Our findings might be helpful in the planning of individualized follow-up management and prognostication of further clinical course of BC BM.