title: Surgical resection of brain metastases from breast cancer in the modern era: clinical outcome and prognostic factors.
abstract: BACKGROUND
  Incidence of brain metastases (BM) from breast cancer (BC) is increasing. However, prognostic evaluation and treatment strategies are still a matter of debate.
  
  
  OBJECTIVE
  To describe the clinical outcome of BM from BC treated by neurosurgical resection and to identify the actual prognostic factors in this specific population.
  
  
  METHODS
  We retrospectively reviewed all patients (n=49) with BM from BC treated at our institutions by surgical resection, between December 2001 and July 2011. Patient, tumor and treatment characteristics were recorded.
  
  
  RESULTS
  Median cerebral progression-free survival (CPFS) was 11.3 months (95% Confidence Interval (CI)=6.0-16.6 months) and median overall survival (OS) was 19.4 months (95% CI=16.1-22.7 months). By multivariate analyses, altered Mini Mental Status (MMS) (CPFS: p=0.012, OS: p=0.009), multiple systemic metastases (CPFS: p=0.020, OS: p<0.001) and absence of post-operative chemotherapy (CPFS: p=0.013, OS: p=0.006) had independent adverse prognostic values. Hormonal receptors, Human epidermal growth factor-2 (HER2) and molecular subtype were not significantly correlated to survival.
  
  
  CONCLUSIONS
  Surgical resection is an effective treatment in selected patients with BM from BC. MMS, number of systemic metastases and the use of postoperative systemic treatment are associated with better outcome.
authors: Departements of Medical Oncology, Paoli-Calmettes Institut, Marseille, France.
authors: Emeline
authors: E
authors: Tabouret
authors: Philippe
authors: P
authors: Metellus
authors: Agnes
authors: A
authors: Tallet-Richard
authors: Dominique
authors: D
authors: Figarella-Branger
authors: Emmanuelle
authors: E
authors: Charaffe-Jauffret
authors: Patrice
authors: P
authors: Viens
authors: Anthony
authors: A
authors: Gonçalves
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Brain metastases; breast cancer; prognostic factors; surgical resection