Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
J Neurooncol. 2024 Sep;169(2):309-316. doi: 10.1007/s11060-024-04735-x. Epub 2024 Jun 12.
We aimed to identify factors associated with the extent of brain metastases in patients with breast cancer to help distinguish brain oligometastases (1-4 brain metastases) from extensive metastases (5 or more brain metastases).
This retrospective observational study included 100 female patients diagnosed with brain metastases from breast cancer at a single institution between January 2011 and April 2022. Patient demographics and tumor characteristics were compared between the brain oligometastases group and the extensive metastases group. Multivariable logistic regression analysis was performed to determine the independent factors, including age at initial diagnosis, initial stage, breast cancer subtype, detection time of brain metastases, and de novo or recurrent status of the metastatic disease. In a subgroup analysis of patients with brain oligometastases, demographic and tumor characteristics were compared between patients with single and two-four brain metastases.
Of the 100 patients, 56 had brain oligometastases, while 44 had extensive brain metastases. The multivariable logistic regression analysis revealed that only the de novo/recurrent status of metastatic breast cancer was significantly associated with the extent of brain metastasis (p = 0.023). In the subgroup analysis of 56 patients with brain oligometastases, those diagnosed at an earlier stage were more likely to have a single brain metastasis (p = 0.008).
Patients with de novo metastatic breast cancer are more likely to develop extensive brain metastases than those with recurrent metastatic breast cancer. This insight could influence the development of tailored approaches for monitoring and treating brain metastases, supporting the potential advantages of routine brain screening for patients newly diagnosed with stage IV breast cancer.
我们旨在确定与乳腺癌患者脑转移范围相关的因素，以帮助区分脑寡转移（1-4 个脑转移）与广泛转移（5 个或更多脑转移）。
本回顾性观察性研究纳入了 2011 年 1 月至 2022 年 4 月期间在一家医疗机构诊断为脑转移的 100 例女性乳腺癌患者。比较脑寡转移组和广泛转移组的患者人口统计学和肿瘤特征。采用多变量逻辑回归分析确定独立因素，包括初诊年龄、初始分期、乳腺癌亚型、脑转移的检出时间、转移性疾病的初发或复发状态。对脑寡转移患者进行亚组分析，比较单发和 2-4 个脑转移的患者的人口统计学和肿瘤特征。
100 例患者中，56 例为脑寡转移，44 例为广泛脑转移。多变量逻辑回归分析显示，只有转移性乳腺癌的初发/复发状态与脑转移范围显著相关（p=0.023）。在脑寡转移的 56 例患者的亚组分析中，较早诊断的患者更有可能出现单发脑转移（p=0.008）。
初发转移性乳腺癌患者比复发转移性乳腺癌患者更有可能发生广泛脑转移。这一认识可能会影响针对脑转移监测和治疗的个体化方法的制定，支持对新诊断为 IV 期乳腺癌患者进行常规脑筛查的潜在优势。
