Brain Metastasis in Triple-Negative Breast Cancer

IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Breast Journal Pub Date : 2024-09-30 DOI:10.1155/2024/8816102
Eduarda Bustamante, Fresia Casas, Renato Luque, Luis Piedra, Shamir Barros-Sevillano, Diego Chambergo-Michilot, J. Smith Torres-Roman, Alexis Narvaez-Rojas, Zaida Morante, Daniel Enriquez-Vera, Anshumi Desai, Cesar Razuri, Gabriel De la Cruz-Ku, Jhajaira Araujo
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Abstract

Background. Breast cancer is an important cause of cancer-related death in women worldwide and represents the second most frequent cause of brain metastases after lung cancer. The aim of this study was to determine the characteristics and outcomes of triple-negative breast cancer (TNBC) patients with brain metastasis (BM). Methods. We retrospectively reviewed a cohort of patients diagnosed with TNBC at the “Instituto Nacional de Enfermedades Neoplasicas” (period 2000–2014) to evaluate patients who developed BM. Survival rates were assessed by the Kaplan–Meier method, and prognostic factors were identified with the Cox regression analysis. Results. Of a total of 2007 TNBC patients, 193 (9.62%) developed BM. Of these, 169 stages I–III patients with a median age of 45 years (range:21–78) were included. The stage in this cohort was 4 (2.4%) clinical stage (CS) I, 23 (13.6%) with CS II and 142 (84.0%) with CS III. Most of these patients presented ECOG ≥2 (68.6%). The most common symptom was headache (74.0%), followed by nausea-vomiting (46.7%). Imaging showed that 80 patients (53.0%) had ≥1 metastatic brain lesion. Regarding the treatment of BM in this cohort, 132 patients (84.6%) received radiotherapy (RT), 2 (1.5%) surgery, and 6 (4.5%) surgery plus RT. The overall survival (OS) rate of BM was 59.8%, 37.3%, and 15.0% at 3, 6, and 12 months, respectively. A multivariate analysis showed RT to be the only factor with a positive impact on the OS of BM (hazard ratio (HR) = 0.48, 95% confidence interval (CI):0.30-0.77, and p = 0.002), while ECOG ≥2 was associated with a worse OS (HR = 1.69, 95%CI:1.15–2.48, and p = 0.007). Conclusion. Despite the poor prognosis of TNBC patients who develop BM, RT showed a benefit in OS rates, while ECOG ≥2 was the only prognostic factor associated with a worse OS. These results may be useful for multidisciplinary teams for treatment planning in patients with TNBC and BM.

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三阴性乳腺癌的脑转移
背景。乳腺癌是全球女性癌症相关死亡的重要原因,也是仅次于肺癌的第二大脑转移病因。本研究旨在确定三阴性乳腺癌(TNBC)脑转移(BM)患者的特征和预后。研究方法我们对 "国家肿瘤研究所"(Instituto Nacional de Enfermedades Neoplasicas)确诊的 TNBC 患者队列(2000-2014 年)进行了回顾性研究,以评估发生脑转移的患者。采用 Kaplan-Meier 法评估生存率,并通过 Cox 回归分析确定预后因素。结果在2007例TNBC患者中,有193例(9.62%)出现骨髓瘤。其中,169例为I-III期患者,中位年龄为45岁(21-78岁)。临床分期(CS)为 I 期的患者有 4 人(2.4%),CS II 期患者有 23 人(13.6%),CS III 期患者有 142 人(84.0%)。大多数患者的 ECOG ≥2(68.6%)。最常见的症状是头痛(74.0%),其次是恶心呕吐(46.7%)。影像学检查显示,80 名患者(53.0%)有≥1 个转移性脑病灶。关于该组患者的脑转移治疗,132 名患者(84.6%)接受了放射治疗(RT),2 名患者(1.5%)接受了手术治疗,6 名患者(4.5%)接受了手术加 RT 治疗。在3、6和12个月时,BM的总生存率(OS)分别为59.8%、37.3%和15.0%。多变量分析显示,RT是唯一对BM的OS有积极影响的因素(危险比(HR)=0.48,95%置信区间(CI):0.30-0.77,P=0.002),而ECOG≥2与较差的OS相关(HR=1.69,95%CI:1.15-2.48,P=0.007)。结论尽管发生BM的TNBC患者预后较差,但RT对OS率有益处,而ECOG≥2是唯一与OS较差相关的预后因素。这些结果可能有助于多学科团队为 TNBC 和 BM 患者制定治疗计划。
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来源期刊
Breast Journal
Breast Journal 医学-妇产科学
CiteScore
4.00
自引率
0.00%
发文量
47
审稿时长
4-8 weeks
期刊介绍: The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.
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