title: Limited overall survival in patients with brain metastases from triple negative breast cancer.
abstract: Patients with breast cancer, which lacks ER, PR, and HER2; "triple negative" (TNBC), are at increased risk of brain metastases (BMs). However, the impact of modern therapy on the risk of BMs and outcomes remains largely unknown. In this retrospective, single-institution study we assessed the incidence of BMs, the therapeutic options, and overall survival, in a recent cohort of patients with TNBC. Women diagnosed with early stage TNBC from January 1, 1998 to December 31, 2007 were identified through institutional databases. Electronic medical records were reviewed to assess patterns of recurrence, treatment, and survival. In total, 1,323 patients, median age 53 years (range 20-91), were identified. There were 298 patients (23%) who developed metastatic disease, of whom, 99 (33%) developed BMs, representing 7.5% of the entire cohort. Following BM diagnosis, treatment consisted of: radiotherapy 87 (88%) patients, resection 26 (26%) patients, and systemic chemotherapy 70 (71%) patients, with a median of 1.0 (range 0-8) chemotherapy regimens. The actuarial median survival from diagnosis of BMs is 5 months (95% CI 4-7 months). This single-institution, retrospective study confirms that the prognosis for patients with BMs from TNBC remains poor. This group of patients urgently needs improved therapies.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. morrisp1@mskcc.org
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Morris
authors.forename: Conleth G
authors.initials: CG
authors.lastname: Murphy
authors.forename: Divya
authors.initials: D
authors.lastname: Mallam
authors.forename: Melissa
authors.initials: M
authors.lastname: Accordino
authors.forename: Sujata
authors.initials: S
authors.lastname: Patil
authors.forename: Jane
authors.initials: J
authors.lastname: Howard
authors.forename: Antonio
authors.initials: A
authors.lastname: Omuro
authors.forename: Kathryn
authors.initials: K
authors.lastname: Beal
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Seidman
authors.forename: Clifford A
authors.initials: CA
authors.lastname: Hudis
authors.forename: Monica N
authors.initials: MN
authors.lastname: Fornier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary*; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008577:Meningeal Neoplasms / Q000175:diagnosis; D008875:Middle Aged; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human