Survival Analysis Of Correlation Between Clinicopathological Features And Brain Metastasis Of Triple Negative Breast Cancer

Objective: To explore the high risk factors and prognostic factors of brain metastasis in patients with triple negative breast cancer((TNBC)),to guide clinical screening of patients with high risk of brain metastasis,and to provide theoretical basis for clinical follow-up and treatment.Methods: The clinicopathological data of 437 patients with stage Ⅰ-Ⅲtriple negative breast cancer diagnosed in our hospital from January 2010 to December2016 were studied retrospectively.The life table method was used to calculate the total brain metastasis rate at each time point.Kaplan-Meier method and Cox retrospective model were used to analyze the risk factors of brain metastasis.Then the clinical and survival data of patients with brain metastasis were analyzed.The survival rate at each time point was calculated by Kaplan-Meier method.Univariate and Cox retrospective models were used to analyze the prognostic factors of patients with brain metastasis.Results:(1)During the median follow-up period of 58 months,89 patients(20.4%)had brain metastasis.The cumulative brain metastasis rates of 6 months,1 year,2 years,3years and 5 years in TNBC patients were 1.38%,5.75%,12.94%,17.63% and 21.26%,respectively.(2)Multivariate analysis showed that age at first diagnosis,tumor size,lymph node metastasis status,Ki-67 index and unoperated were the risk factors of brain metastasis in patients with triple negative breast cancer.(3)The patients with brain metastasis were followed up for 2 years and the median survival time was 4.87 months.The 1,3,6,12 and 24month survival rates were 84.27%,60.67%,34.83%,15.69% and6.64%,respectively.Multivariate analysis showed that age at first diagnosis Ki-67 index,other metastatic sites and treatment regimens after brain metastasis were closely related to the prognosis of patients with TNBC brain metastasis.Conclusion: Patients with TNBC are prone to brain metastasis within the first 2-3 years after the diagnosis of breast cancer.Age 35 years old,late clinical stage,Ki-67 ≥ 30% and no operation are the high risk factors for brain metastasis of triple negative breast cancer.The survival rate of TNBC patients with brain metastasis is low(the median survival time is 4.87 months).The age≥ 60 years old and accompanied with other metastatic sites may be the risk factors for the prognosis of the patients.The comprehensive treatment of chemotherapy and radiotherapy may be the protective factors for the prognosis of the patients.