title: Prognostic factors and survival of patients with brain metastasis from breast cancer who underwent craniotomy.
abstract: Brain metastasis (BM) in patients with breast cancer is a catastrophic event that results in poor prognosis. Identification of prognostic factors associated with breast cancer brain metastases (BCBM) could help to identify patients at risk. The aim of this study was to assess clinical characteristics, prognostic factors, and survival of patients with BCBM who had craniotomy and resection in a series of patients treated with modern multimodality therapy. We analyzed 42 patients with BCBM who underwent resection. Patients were diagnosed with breast cancer between April 1994 and May 2010. Cox proportional hazards regression was selected to describe factors associated with time to BM, survival from the date of first recurrence, and overall survival (OS). Median age was 51 years (range 24-74). Median follow-up was 4.2 years (range 0.6-18.5). The proportion of the biological subtypes of breast cancer was ER+/HER2- 25%, ER+/HER2+ 15%, ER-/HER2+ 30%, and ER-/HER2- 30%. Median OS from the date of primary diagnosis was 5.74 years. Median survival after diagnosis of BM was 1.33 years. In multivariate Cox regression analyses, stage was the only factor associated with shorter time to the development of BM (P = 0.033), whereas age was the only factor associated with survival from the date of recurrence (P = 0.027) and with OS (P = 0.037). Stage at primary diagnosis correlated with shorter time to the development of BM, while age at diagnosis was associated with shorter survival in BCBM. None of the other clinical factors had influence on survival.
authors.affiliation: Division of Hematology and Oncology, University of Pittsburgh Cancer Institute, 5150 Centre Avenue, Pittsburgh, Pennsylvania, 15232.
authors.forename: José Pablo
authors.initials: JP
authors.lastname: Leone
authors.affiliation: Division of Hematology and Oncology, University of Pittsburgh Cancer Institute, 5150 Centre Avenue, Pittsburgh, Pennsylvania, 15232.
authors.forename: Adrian V
authors.initials: AV
authors.lastname: Lee
authors.affiliation: Division of Hematology and Oncology, University of Pittsburgh Cancer Institute, 5150 Centre Avenue, Pittsburgh, Pennsylvania, 15232.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Brufsky
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D001932:Brain Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D003399:Craniotomy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: Brain metastasis; breast cancer; craniotomy; prognostic factors; survival