Department of Breast Radiotherapy, The Third Clinical College of Xinjiang Medical University (Affiliated Tumor Hospital), Urumqi, Xinjiang, China.
J Cancer Res Ther. 2024 Aug 1;20(4):1314-1322. doi: 10.4103/jcrt.jcrt_2079_21. Epub 2024 Aug 29.
This retrospective study is to explore the risk factors and prognostic factors of brain metastases of triple-negative breast cancer (TNBC) in a single center.
Clinical data of patients with stages I-III TNBC were collected. The Kaplan-Meier method, log-rank test, and stepwise COX regression were performed.
The 437 patients with stages I-III TNBC were followed up for five years. Among them, 89 cases (20.4%) developed brain metastases, and they were followed up for 2 years after brain metastasis. The cumulative brain metastasis rates of TNBC patients at six months, one year, two years, three years, and five years were 1.38%, 5.75%, 12.94%, 17.63%, and 21.26%, respectively. Multivariate analysis suggested that the first diagnosis age ≤35 years old, advanced pathological stage, lymph node metastasis, and Ki-67 ≥30% represented the risk factors for brain metastasis. In contrast, the surgical method was a protective factor for brain metastasis. The median survival time after brain metastasis was 4.87 months. The survival rates at one, three, six, 12, and 24 months were 84.27%, 60.67%, 34.83%, 15.69%, and 6.64%, respectively. The age >60 years at first diagnosis, Ki-67 ≥30%, local recurrence, and distant metastasis were closely related to the poor prognosis of TNBC patients with brain metastases, while radiotherapy alone, systemic therapy, and combined chemotherapy and radiotherapy represented the prognostic protective factors.
Patient age, Ki-67 level, metastasis, and treatment methods are the risk factors and prognostic factors for brain metastasis of TNBC. Surgical resection of the primary lesion during the first treatment is essential to reduce the incidence of brain metastases. Close postoperative follow-up (such as brain magnetic resonance imaging [MRI]) within 2-3 years after surgery is recommended to improve the prognosis.
本回顾性研究旨在探讨单中心三阴性乳腺癌（TNBC）脑转移的危险因素和预后因素。
收集 I-III 期 TNBC 患者的临床资料。采用 Kaplan-Meier 法、log-rank 检验和逐步 COX 回归分析。
437 例 I-III 期 TNBC 患者随访 5 年，其中 89 例（20.4%）发生脑转移，脑转移后随访 2 年。TNBC 患者脑转移 6 个月、1 年、2 年、3 年和 5 年的累积脑转移率分别为 1.38%、5.75%、12.94%、17.63%和 21.26%。多因素分析提示，初诊年龄≤35 岁、病理分期较晚、淋巴结转移、Ki-67≥30%是脑转移的危险因素，而手术方式是脑转移的保护因素。脑转移后中位生存时间为 4.87 个月，脑转移后 1、3、6、12 和 24 个月的生存率分别为 84.27%、60.67%、34.83%、15.69%和 6.64%。初诊年龄>60 岁、Ki-67≥30%、局部复发、远处转移与 TNBC 脑转移患者预后不良密切相关，而单纯放疗、全身治疗、联合化疗和放疗则是预后保护因素。
患者年龄、Ki-67 水平、转移及治疗方法是 TNBC 脑转移的危险因素和预后因素。在首次治疗中对原发病灶进行手术切除对于降低脑转移的发生率至关重要。建议在手术后 2-3 年内进行密切的术后随访（如脑磁共振成像[MRI]），以改善预后。
