Daniels Joseph, Kyei Kofi Adesi, Walubo Ronald, Nyantakyi Andrew Yaw, Ayabilah Edwina Ayaaba, Tackie Judith Naa Odey
National Centre for Radiotherapy, Oncology, and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana.
Department of Radiography, University of Ghana, Accra, Ghana.
PLoS One. 2025 Aug 8;20(8):e0329308. doi: 10.1371/journal.pone.0329308. eCollection 2025.
Breast cancer remains a leading cause of cancer-related mortality among women globally. While advances in early diagnosis and systemic therapies have improved survival, they have also increased the likelihood of brain metastases over time, particularly in low-resource settings where limited diagnostic and treatment capacity exacerbates the burden of late-stage disease. The study aimed to determine the prevalence and describe the clinicopathological characteristics of breast cancer patients diagnosed with brain metastasis in a limited-resource healthcare setting. This research was a single-institution-based quantitative cross-sectional study. Socio-demographic, clinical and pathological data were extracted from patients' medical records as well as the hospital-based cancer registry. Data were analyzed using STATA software (version 16). Descriptive and logistic regression analyses were performed. The study involved 144 adult female metastatic breast cancer patients with a mean age of 48.7 years (SD 11.3). The prevalence of brain metastasis was 17.5%. Only 4.9% presented with de novo brain metastasis, p < 0.001. Bone metastases were present in 31.9% whereas 26.4% and 12.5% had concurrent lung and liver metastasis respectively. In all, 38.9% had grade III tumors. Also, 50.6% were categorized as recursion partition analysis (RPA) class II whereas 49.3% had a performance status of ECOG 2. A considerable majority (86.8%) were treated with palliative intent whereas 13.2% received best supportive care only. In total, 86.8% underwent radiotherapy whereas 81.3% received systemic treatments, with chemotherapy being the most frequently utilized modality (73.5%). Most patients (88%) were treated with 2-dimensional radiotherapy whereas 3.2% received hippocampal-sparing intensity-modulated radiotherapy. The high prevalence of brain metastasis among breast cancer patients with distant metastases reflects the challenges associated with late-stage breast cancer presentation and limited access to advanced diagnostic and therapeutic interventions in limited-resource healthcare settings.
乳腺癌仍然是全球女性癌症相关死亡的主要原因。虽然早期诊断和全身治疗的进展提高了生存率，但随着时间的推移，它们也增加了脑转移的可能性，特别是在资源有限的环境中，有限的诊断和治疗能力加剧了晚期疾病的负担。该研究旨在确定在资源有限的医疗环境中被诊断为脑转移的乳腺癌患者的患病率，并描述其临床病理特征。这项研究是一项基于单一机构的定量横断面研究。社会人口统计学、临床和病理数据从患者的病历以及基于医院的癌症登记处提取。使用STATA软件（版本16）进行数据分析。进行了描述性和逻辑回归分析。该研究纳入了144名成年女性转移性乳腺癌患者，平均年龄为48.7岁（标准差11.3）。脑转移的患病率为17.5%。仅4.9%的患者表现为新发脑转移，p < 0.001。31.9%的患者有骨转移，而分别有26.4%和12.5%的患者同时有肺和肝转移。总体而言，38.9%的患者患有III级肿瘤。此外，50.6%被归类为递归分区分析（RPA）II级，而49.3%的患者体能状态为ECOG 2。绝大多数（86.8%）患者接受姑息性治疗，而13.2%的患者仅接受最佳支持治疗。总共有86.8%的患者接受了放疗，81.3%的患者接受了全身治疗，化疗是最常用的治疗方式（73.5%）。大多数患者（88%）接受二维放疗，而3.2%的患者接受了海马体保护调强放疗。远处转移的乳腺癌患者中脑转移的高患病率反映了晚期乳腺癌表现以及在资源有限的医疗环境中难以获得先进诊断和治疗干预措施所带来的挑战。
