title: Outcome and clinico-biological characteristics of advanced breast cancer patients with surgically resected brain metastases: a multidisciplinary approach.
abstract: BACKGROUND
  Despite improvements in brain surgery and radiotherapy, patients with brain metastases (BM) from breast cancer still have a poor prognosis. The aim of the present study is to evaluate the outcome of a multimodal therapeutic strategy in an unselected cohort of patients.
  
  
  METHODS
  We retrospectively reviewed 24 breast cancer patients who developed BM and were treated with brain surgery, radiotherapy, and/or systemic therapy in the same institutions.
  
  
  RESULTS
  Primary treatment for BM was surgery in the whole cohort, radiotherapy in 11 patients, radiotherapy combined with systemic therapy in nine patients, and systemic therapy as single treatment in six patients (chemo/targeted therapy n= 4; hormonal therapy n=2). The median time from breast cancer diagnosis to brain surgery was 57.6 months (range 1.8-130.7 months). The overall survival from surgery for BM was 22 months and the overall survival from BM surgery by presence of other metastatic sites at surgery was 25 months for patients with BM only and 11 months for patients with other metastatic sites (p=0.046).
  
  
  CONCLUSIONS
  Although this study is retrospective and limited by the small number of patients, the overall survival of 22 months from the time of brain surgery represents an excellent outcome. The multidisciplinary approach that combines the efforts of specialists from different disciplines leads to satisfactory results for patients in terms of survival in the current clinical practice and prospective subtype-oriented trials are urgently required in this category of patients.
authors: Department of Medicine, Division of Medical Senology, European Institute of Oncology, Milan, Italy.
authors: Elisabetta
authors: E
authors: Munzone
authors: Cecilia
authors: C
authors: Casali
authors: Gaetano
authors: G
authors: Aurilio
authors: Edoardo
authors: E
authors: Botteri
authors: Alessandro
authors: A
authors: Perin
authors: Giuliana
authors: G
authors: Pelicci
authors: Paola
authors: P
authors: Brescia
authors: Angela
authors: A
authors: Sciandivasci
authors: Laura
authors: L
authors: Adamoli
authors: Giuseppe
authors: G
authors: Viale
authors: Francesco
authors: F
authors: Dimeco
keywords: brain metastases; breast cancer; medical treatments; surgery; survival outcomes
references: J Clin Neurosci. 2011 Nov;18(11):1429-34
references: 21868230
references: Cancer. 1983 Dec 15;52(12):2349-54
references: 6640506
references: Ann Oncol. 2011 Oct;22(10):2227-33
references: 21343379
references: Clin Cancer Res. 2007 Mar 15;13(6):1648-55
references: 17363517
references: Eur J Cancer. 2010 May;46(7):1204-10
references: 20303257
references: J Clin Oncol. 2011 Jan 10;29(2):134-41
references: 21041710
references: Acta Oncol. 2013 Nov;52(8):1649-56
references: 23327413
references: Am Soc Clin Oncol Educ Book. 2012;:28-38
references: 24451704
references: Cancer. 1979 Nov;44(5):1913-8
references: 498057
references: Am J Pathol. 2005 Oct;167(4):913-20
references: 16192626
references: Histopathology. 2002 Sep;41(3A):154-61
references: 12405947
references: Cancer. 2008 Nov 15;113(10):2638-45
references: 18833576
references: Br J Cancer. 2009 Mar 24;100(6):894-900
references: 19240719