Incidence of and survival following brain metastases among women with inflammatory breast cancer.
BACKGROUND
The purpose of this study was to determine the incidence of and survival following brain metastases among women with inflammatory breast cancer (IBC).


METHODS
Two hundred and three women with newly diagnosed stage III/IV IBC diagnosed from 2003 to 2008, with known Human epidermal growth factor receptor 2 (HER2) and hormone receptor status, were identified. Cumulative incidence of brain metastases was computed. Survival estimates were computed using the Kaplan-Meier product limit method. Multivariable Cox proportional hazards models were fitted to explore the relationship between breast tumor subtype and time to brain metastases.


RESULTS
Median follow-up was 20 months. Thirty-two (15.8%) patients developed brain metastases with a cumulative incidence at 1 and 2 years of 2.7% and 18.7%, respectively. Eleven (5.3%) patients developed brain metastases as the first site of recurrence with cumulative incidence at 1 and 2 years of 1.6% and 5.7%, respectively. Compared with women with triple receptor-negative IBC, those with hormone receptor-positive/HER2-negative disease [hazard ratio (HR) = 0.55, 95% confidence interval (CI) 0.19-1.51, P = 0.24] had a decreased risk of developing brain metastases, and those with HER2-positive disease (HR = 1.02, 95% CI 0.43-2.40, P = 0.97) had an increased risk of developing brain metastases, although these associations were not statistically significant. Median survival following a diagnosis of brain metastases was 6 months.


CONCLUSIONS
Women with newly diagnosed IBC have a high early incidence of brain metastases associated with poor survival and may be an ideal cohort to target for site-specific screening.
Dawood
S
S
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA; Department of Medical Oncology, Dubai Hospital, Dubai, United Arab Emirates. Electronic address: ssdawood@dohms.gov.ae.
Ueno
N T
NT
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Valero
V
V
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Andreopoulou
E
E
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Hsu
L
L
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Lara
J
J
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Woodward
W
W
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Buchholz
T A
TA
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Hortobagyi
G N
GN
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Cristofanilli
M
M
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000401:mortality* / Q000556:secondary*; D002277:Carcinoma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D058922:Inflammatory Breast Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016019:Survival Analysis; D055815:Young Adult