title: Factors influencing the time to development of brain metastases in breast cancer.
abstract: This retrospective study analyzed risk factors influencing the time to development of brain metastases with the aim to facilitate the definition of a high-risk population among breast cancer patients. One hundred seventy-four breast cancer patients with brain metastases, treated with whole brain radiotherapy, were evaluated. Statistical analysis included hormone receptor status, HER2/neu status, tumour grading, tumour stage, young age at the time of diagnosis, adjuvant systemic treatment, palliative systemic treatment, metastatic sites (if brain metastases were not the first site of recurrence), and immunotherapy with trastuzumab. Time to development of brain metastases was significantly prolonged by systemic palliative treatment (p< or =0.0001) whereas high tumour grading (p< or =0.04) and trastuzumab therapy (p< or =0.04) significantly shortened this time span. Patients with the brain as first metastatic site, age>35 (p< or =0.001) and stage III (p< or =0.018) at the time of diagnosis had a significantly shorter time to development for brain lesions. These factors should be further validated by a prospective trial to identify a high-risk population amongst breast cancer patients and enable the development of screening programs for early detection.
authors.affiliation: Department of Radiotherapy and Radiobiology, Medical University of Vienna, Vienna, Austria. sabine.fromm@chello.at
authors.forename: Sabine
authors.initials: S
authors.lastname: Fromm
authors.forename: Rupert
authors.initials: R
authors.lastname: Bartsch
authors.forename: Margaretha
authors.initials: M
authors.lastname: Rudas
authors.forename: Alexander
authors.initials: A
authors.lastname: de Vries
authors.forename: Catharina
authors.initials: C
authors.lastname: Wenzel
authors.forename: Guenther G
authors.initials: GG
authors.lastname: Steger
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Zielinski
authors.forename: Richard
authors.initials: R
authors.lastname: Poetter
authors.forename: Karin
authors.initials: K
authors.lastname: Dieckmann
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001317:Austria; D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D000068878:Trastuzumab
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab