Lee Gha-Hyun, Seol Young Mi, Choi Young Jin, Kim Hyojeong
Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan, Republic of Korea.
Division of Hemato-Oncology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan, Republic of Korea.
Medicine (Baltimore). 2025 Mar 14;104(11):e41827. doi: 10.1097/MD.0000000000041827.
Female breast cancer is among the most prevalent cancers globally, often metastasizing to the brain. Despite advancements in treatment, brain metastasis incidence is rising, with a poor prognosis. Moreover, limited data exist on how breast cancer subtypes and patient characteristics impact survival. This study aimed to investigate prognostic factors affecting breast cancer patients with brain metastasis. We retrospectively reviewed 131 breast cancer patients with brain metastasis diagnosed at a single institution between 2010 and 2020. Demographic, clinical, pathological, and radiographic variables were analyzed. The median interval between breast cancer diagnosis and brain metastasis was 27 months. Patients diagnosed with a higher stage of breast cancer (median survival: stage 1: 97.2 months, stage 2: 44.4 months, stage 3: 38.1 months, stage 4: 13.0 months, P < .001) and those with ER-negative tumors (median survival: negative 25.3 months, positive 37.5 months, P = .034) had a shorter time between initial diagnosis and brain metastasis. Median survival after brain metastasis was 8.0 months. Multivariate analysis showed that triple-negative breast cancer was correlated to a high risk of death after brain metastasis (hazard ratio = 2.320, P < .001). Higher histological grade, low-performance status, extensive brain metastases, and leptomeningeal seeding was associated with shorter survival. Systemic chemotherapy after brain metastasis was the only treatment that improved survival (hazard ratio = 0.332, P < .001). The study suggests potential benefits of aggressive treatment, especially in nontriple-negative breast cancer subtypes, limited brain metastases, and good overall health. Further research with larger patient populations is needed.
女性乳腺癌是全球最常见的癌症之一,常转移至脑部。尽管治疗有所进展,但脑转移的发生率仍在上升,预后较差。此外,关于乳腺癌亚型和患者特征如何影响生存的数据有限。本研究旨在调查影响乳腺癌脑转移患者的预后因素。我们回顾性分析了2010年至2020年在单一机构确诊的131例乳腺癌脑转移患者。对人口统计学、临床、病理和影像学变量进行了分析。乳腺癌诊断与脑转移之间的中位间隔为27个月。诊断为乳腺癌更高分期的患者(中位生存期:1期:97.2个月,2期:44.4个月,3期:38.1个月,4期:13.0个月,P < .001)以及雌激素受体阴性肿瘤患者(中位生存期:阴性25.3个月,阳性37.5个月,P = .034)在初次诊断与脑转移之间的时间较短。脑转移后的中位生存期为8.0个月。多因素分析显示,三阴性乳腺癌与脑转移后高死亡风险相关(风险比 = 2.320,P < .001)。更高的组织学分级、低功能状态、广泛的脑转移和软脑膜播散与较短的生存期相关。脑转移后进行全身化疗是唯一能改善生存的治疗方法(风险比 = 0.332,P < .001)。该研究表明积极治疗可能有益,尤其是在非三阴性乳腺癌亚型、有限的脑转移和总体健康状况良好的患者中。需要对更大的患者群体进行进一步研究。