title: Treatment outcomes and prognostic factors for patients with brain metastases from breast cancer of each subtype: a multicenter retrospective analysis.
abstract: To define prognostic factors for breast cancer patients with brain metastases, compare their clinical courses and prognoses according to breast cancer subtypes, and analyze the causes of death in such patients. We retrospectively analyzed 1,466 patients diagnosed with brain metastases between April 1, 2001 and December 31, 2012, from 24 institutions of the Japan Clinical Oncology Group. Overall, 1,256 patients with brain metastases were included. The median overall survival (OS) was 8.7 months (95 % confidence interval [CI] 7.8-9.6 months). Univariate and multivariate analyses revealed that patients diagnosed with brain metastasis within 6 months of metastatic breast cancer diagnoses, asymptomatic brain disease, or HER2-positive/estrogen receptor-positive tumors had increased OS. Median OS after the development of brain metastases was 9.3 months (95 % CI 7.2-11.3) for the luminal type, 16.5 months (95 % CI 11.9-21.1) for the luminal-HER2 type, 11.5 months (95 % CI 9.1-13.8) for the HER2 type, and 4.9 months (95 % CI 3.9-5.9) for the triple-negative type. Luminal-HER2 type patients had significantly longer OS than patients with the luminal type (hazard ratio [HR] = 1.50, P < 0.0001) and triple-negative type (HR = 1.97, P < 0.0001); no significant differences were noted compared to HER2-type patients (HR = 1.19, P = 0.117). The prognosis and clinical course of patients with brain metastasis from breast cancer before and after developing brain metastases vary according to subtype. Focusing on the subtypes of breast cancer can optimize the prevention, early detection, and improved treatment of brain metastases.
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan, niikura@is.icc.u-tokai.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Niikura
authors.forename: Naoki
authors.initials: N
authors.lastname: Hayashi
authors.forename: Norikazu
authors.initials: N
authors.lastname: Masuda
authors.forename: Seiki
authors.initials: S
authors.lastname: Takashima
authors.forename: Rikiya
authors.initials: R
authors.lastname: Nakamura
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Watanabe
authors.forename: Chizuko
authors.initials: C
authors.lastname: Kanbayashi
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ishida
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hozumi
authors.forename: Michiko
authors.initials: M
authors.lastname: Tsuneizumi
authors.forename: Naoto
authors.initials: N
authors.lastname: Kondo
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Naito
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Honda
authors.forename: Akira
authors.initials: A
authors.lastname: Matsui
authors.forename: Tomomi
authors.initials: T
authors.lastname: Fujisawa
authors.forename: Risa
authors.initials: R
authors.lastname: Oshitanai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yasojima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Shigehira
authors.initials: S
authors.lastname: Saji
authors.forename: Hiroji
authors.initials: H
authors.lastname: Iwata
mesh_terms: D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D001943:Breast Neoplasms / Q000145:classification* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; 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
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone