Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden.
Breast. 2020 Apr;50:113-124. doi: 10.1016/j.breast.2020.02.007. Epub 2020 Feb 20.
Brain metastases (BM) are a feared progression of breast cancer (BC) with impact on quality of life and survival. Despite improved treatments, it is believed patients suffering from BM are increasing.
To study potential changes in the number of BM, the possible links between BC subgroup and extent of BM with prognosis. To investigate the interval between primary BC/extra cranial recurrence, and diagnosis of BM in the years 1994-2014.
Clinical data from 191 patients with BM diagnosed 1994-2014, was retrieved from charts. Primary tumours where re-evaluated histologically.
There was an increase of BM in 5 years cohorts (1994-99 (n = 9); 2000-04 (n = 36); 2005-09 (n = 60); 2010-14 (n = 86)). We found no difference in the time interval from primary BC to BM but an insignificant increase in time from extra cranial relapse to development of BM in the time periods 1994-2004 and 2005-2014 of 15.5 and 25.0 months (p = 0.0612). Survival after BM was 7 months (95% CI 6-10) with a statistically significant difference between HER2 positive and TNBC with an inferior outcome for the latter (p = 0.018) whilst no differences were present when Luminal BC were compared with HER2 positive BC (p = 0.073).
We show an increase of BM over time whilst the time span from primary BC to BM is unchanged supports earlier findings that adjuvant treatments have little preventive function. Time from extra cranial recurrence to BM was prolonged with one year. Patients with TNBC or more advance extent of BM had the shortest survival with BM.
脑转移（BM）是乳腺癌（BC）患者所面临的一种严重并发症，会对其生活质量和生存产生影响。尽管治疗手段有所改善，但据信患有 BM 的患者数量仍在增加。
研究 BM 数量的潜在变化，BC 亚组与 BM 严重程度与预后之间的可能联系。调查 1994 年至 2014 年间原发性 BC/颅外复发与 BM 诊断之间的间隔时间。
从病历中检索了 191 例 1994 年至 2014 年间诊断为 BM 的患者的临床数据。对原发性肿瘤进行了组织学重新评估。
在 5 年的时间间隔内，BM 的数量有所增加（1994-99 年（n=9）；2000-04 年（n=36）；2005-09 年（n=60）；2010-14 年（n=86））。我们没有发现从原发性 BC 到 BM 的时间间隔有差异，但在 1994-2004 年和 2005-2014 年期间，从颅外复发到发展为 BM 的时间间隔分别增加了 15.5 和 25.0 个月（p=0.0612），这一结果无统计学意义。BM 后的生存时间为 7 个月（95%CI 6-10），HER2 阳性和三阴性乳腺癌（TNBC）之间存在统计学差异，后者的预后较差（p=0.018），而 Luminal BC 与 HER2 阳性 BC 之间的差异无统计学意义（p=0.073）。
我们发现随着时间的推移 BM 的数量增加，而从原发性 BC 到 BM 的时间间隔不变，这支持了早期的研究结果，即辅助治疗的预防作用很小。从颅外复发到 BM 的时间延长了一年。TNBC 或 BM 严重程度较高的患者的 BM 后生存时间最短。
