Breast Disease Center, Peking University First Hospital, Beijing, China.
Breast Disease Center, Peking University First Hospital, Beijing, China.
Asian J Surg. 2022 Nov;45(11):2259-2267. doi: 10.1016/j.asjsur.2021.12.037. Epub 2022 Jan 7.
Although there are current studies on breast cancer brain metastasis, population-level analysis is still lacking. As treatment for metastatic breast cancer has improved, an updated population-level analysis is necessary. Our aim was to use the SEER database to characterize the incidence and survival of patients with brain metastases at the initial diagnosis of breast cancer.
Patients with breast cancer from 2010 to 2018 were identified using the SEER database. The stratified incidence and median survival of patients with BM at diagnosis were described. Multivariate logistic and Cox regression were performed to determine the covariates associated with brain metastasis and survival outcomes, respectively. Multiple comparisons based on Cox proportional hazards model were performed for the analysis of interactive effects on overall survival.
A total of 2,248 patients with brain metastases at the initial diagnosis of breast cancer were identified, accounting for 0.40% of all patients with breast cancer, and 7.26% of patients with metastatic disease. Incidence proportions were highest, and survival outcomes were worst among patients with hormone receptor (HR)-negative human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes. For patients with brain metastases, the prognostic differences among different molecular subtypes have been gradually narrowing, and the survival benefits from various treatment methods have been all increased over time.
Our study provides an updated population-level estimate of the incidence and survival for patients with brain metastases at the diagnosis of breast cancer, thus may help early identification, prognostic stratification and treatment planning for such patients.
尽管目前有关于乳腺癌脑转移的研究，但仍缺乏人群水平的分析。随着转移性乳腺癌治疗的改善，有必要进行更新的人群水平分析。我们的目的是使用 SEER 数据库来描述乳腺癌初始诊断时脑转移患者的发病率和生存情况。
使用 SEER 数据库确定了 2010 年至 2018 年的乳腺癌患者。描述了 BM 患者在诊断时的分层发病率和中位生存情况。进行多变量逻辑和 Cox 回归分析，以确定与脑转移和生存结果相关的协变量。基于 Cox 比例风险模型进行多次比较，以分析对总生存的交互效应。
共确定了 2248 例乳腺癌初始诊断时脑转移的患者，占所有乳腺癌患者的 0.40%，转移性疾病患者的 7.26%。激素受体（HR）阴性人表皮生长因子受体 2（HER2）阳性和三阴性亚型的患者发病率比例最高，生存结果最差。对于脑转移患者，不同分子亚型之间的预后差异逐渐缩小，各种治疗方法的生存获益随着时间的推移而增加。
我们的研究提供了乳腺癌初始诊断时脑转移患者发病率和生存情况的最新人群水平估计，从而有助于对这些患者进行早期识别、预后分层和治疗计划。
