Radiological Patterns of Brain Metastases in Breast Cancer Patients: A Subproject of the German Brain Metastases in Breast Cancer (BMBC) Registry.
Evidence about distribution patterns of brain metastases with regard to breast cancer subtypes and its influence on the prognosis of patients is insufficient. Clinical data, cranial computed tomography (CT) and magnetic resonance imaging (MRI) scans of 300 breast cancer patients with brain metastases (BMs) were collected retrospectively in four centers participating in the Brain Metastases in Breast Cancer Registry (BMBC) in Germany. Patients with positive estrogen (ER), progesterone (PR), or human epidermal growth factor receptor 2 (HER2) statuses, had a significantly lower number of BMs at diagnosis. Concerning the treatment mode, HER2-positive patients treated with trastuzumab before the diagnosis of BMs showed a lower number of intracranial metastases (p < 0.001). Patients with a HER2-positive tumor-subtype developed cerebellar metastases more often compared with HER2-negative patients (59.8% vs. 44.5%, p = 0.021), whereas patients with triple-negative primary tumors had leptomeningeal disease more often (31.4% vs. 18.3%, p = 0.038). The localization of Brain metastases (BMs) was associated with prognosis: patients with leptomeningeal disease had shorter survival compared with patients without signs of leptomeningeal disease (median survival 3 vs. 5 months, p = 0.025). A shorter survival could also be observed in the patients with metastases in the occipital lobe (median survival 3 vs. 5 months, p = 0.012). Our findings suggest a different tumor cell homing to different brain regions depending on subtype and treatment.
Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany. e.laakmann@uke.de.
Elena
E
Laakmann
Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany. i.witzel@uke.de.
Isabell
I
Witzel
Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany. verena.scriba@stud.uke.uni-hamburg.de.
Verena
V
Scriba
Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany. grzyska@uke.de.
Ulrich
U
Grzyska
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany. c.h.zu.eulenburg@umcg.nl.|Department for Epidemiology, University Medical Center Groningen, Groningen 9700, The Netherlands. c.h.zu.eulenburg@umcg.nl.
Christine
C
Zu Eulenburg
German Breast Group GmbH, Neu-Isenburg 63263, Germany. Nicole.Burchardi@gbg.de.
Nicole
N
Burchardi
Department of Gynecology, Agaplesion Diakonie-Clinic Rotenburg, Rotenburg 27356, Germany. Hesse@diako-online.de.
Tobias
T
Hesse
Department of Radiotherapy, Radiology Allianz, Hamburg 22767, Germany. florian.wuerschmidt@radiologische-allianz.de.
Florian
F
Würschmidt
Translational Research Board of the Arbeitsgemeinschaft für Gynäkologische Onkologie (AGO-Trafo), Duesseldorf 40225, Germany. Tanja.Fehm@med.uni-duesseldorf.de.
Tanja
T
Fehm
Breast Study Group of the Arbeitsgemeinschaft für Gynäkologische Onkologie (AGO-B), Frankfurt 65929, Germany. Volker.Moebus@KlinikumFrankfurt.de.
Volker
V
Möbus
German Breast Group GmbH, Neu-Isenburg 63263, Germany. Gunter.vonMinckwitz@gbg.de.
Gunter
G
von Minckwitz
German Breast Group GmbH, Neu-Isenburg 63263, Germany. Sibylle.Loibl@gbg.de.
Sibylle
S
Loibl
Department of Gynecology, Hannover Medical School, Hannover 30625, Germany. Park-Simon.Tjoung-Won@mh-hannover.de.
Tjoung-Won
TW
Park-Simon
Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany. v.mueller@uke.de.
Volkmar
V
Mueller
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005858:Germany; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
brain metastases; breast cancer; pattern; radiological
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