Breast cancer brain metastases: differences in survival depending on biological subtype, RPA RTOG prognostic class and systemic treatment after whole-brain radiotherapy (WBRT).
BACKGROUND
Patients with breast cancer brain metastasis are a heterogeneous group in relation to tumor biology and outcome.


METHODS
The group of 222 breast cancer patients with brain metastasis was divided into three biological subgroups. The propensity of biological subtypes for metastases to the brain and survivals depending on biological subtype, recursive partitioning analysis of Radiation Therapy Oncology Group (RPA RTOG) prognostic class and the use of systemic treatment after whole-brain radiotherapy were assessed.


RESULTS
The rate of patients with triple-negative, human epidermal growth factor receptor 2 (HER2)-positive and luminal breast cancer with brain metastases was 28%, 53% and 19%, respectively. Median survival from brain metastases in triple-negative, HER2-positive and luminal subtype was 3.7, 9 and 15 months, respectively. Median survival from brain metastases in RPA RTOG prognostic class I, II and III was 15, 11 and 3 months, respectively. In the luminal and in the triple-negative subtype, systemic therapy prolonged survival from 3 to 14 months and from 3 to 4 months, respectively. In HER2-positive subtype, median survival without further treatment, after chemotherapy and after chemotherapy with targeted therapy were 3, 8 and 11 months, respectively.


CONCLUSIONS
HER2-positive and triple-negative breast cancers have special predilection for metastases to the brain. Survival from brain metastases depended on performance status and the use of systemic treatment.
Niwińska
A
A
Department of Breast Cancer and Reconstructive Surgery, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland. alphaonetau@poczta.onet.pl
Murawska
M
M
Pogoda
K
K
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology* / Q000532:radiotherapy; D015331:Cohort Studies; D016371:Cranial Irradiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D018299:Neoplasms, Ductal, Lobular, and Medullary / Q000378:metabolism / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
D018719:Erb-b2 Receptor Tyrosine Kinases