Clinical Features Of83Cases With Brain Metastases From Breast Cancer And Predictors Of Survival

Background and ObjectiveIn China, breast cancer has become the biggest threat to women’s health. About25%～40%postoperative patients develop recurrent or metastatic breast cancer. Brain metastases account for10%～30%of all breast cancer patients. The average survival time of brain metastases from breast cancer is only one to two months if not treated promptly, however, the overall survival is less than two years after treatment. Many clinicopathological factors influence the development and prognosis of brain metastases from breast cancer, which have many treating ways. Eighty-three patients with brain metastases from breast cancer diagnosed at Henan Province Cancer Hospital and First Affiliated Hospital of Zhengzhou University between1998and2011were retrospectively evaluated. By analyzing clinicopathological data of these patients, we could clear the relationship between the development of brain metastasis and these factors, find out predictors of survival and compare with different treating ways which effect on overall survival.Material and MethodsA total of eighty-three patients with brain metastases from breast cancer diagnosed at Henan Province Cancer Hospital and First Affiliated Hospital of Zhengzhou University from April1998to May2011were retrospectively analyzed in this study. The clinicopathological data of these patients were gathered, including general conditions, pathological type, TNM-staging, histological grade, tumor genotype, positive lymph node numbers, numbers of brain metastasis, serum tumor marks’lever and treating ways. They might have important impacts on time to development of brain metastases (TTBM), brain metastases-free survival (BMFS) and overall survival (OS). SPSS17.0software package was used to perform all statistical analysis.Results1. Median TTBM was29.8months (range between0～148.3months), and median BMFS was19months (range between0～42.7months). TTBM was influenced by pathological type, TNM-staging, histological grade and tumor genotype, while, no clinicopathological factors had effects on BMFS.2. To the end of the follow-up, the median survival time of all patients was9.6months (0.3-32.6months). The one-and two-year survival rates of the patients were41.0%and7.2%, respectively. Univariate analysis showed some statistically significant factors such as numbers of brain metastasis, performance status score when brain metastases (BM) occured, serum CEA or CA125level at BM (P<0.05).3. Treating ways affected overall survival of patients with brain metastases from breast cancer also. Patients who only accepted supportive treatment had a median survival of0.9months. The monotherapy group, the combined treatment group and the surgical resection group had a median survival time of7.8months,14.5months and18.8months, respectively. The radiotherapy group and systemic treatment group had a median survival time of4.2months and8.0months, respectively.4. Multivariate Cox analysis demonstrated that performance status score, serum CEA level and treating ways at BM were the independent prognostic factors for overall survival (P<0.05). Conclusion1. Time to development of brain metastases was influenced by pathological type, TNM-staging, histological grade and tumor genotype.2. Patients who accepted combined treatment have a longer survival time compared with the monotherapy group. The surgical resection group have a better survival compared with the systemic treatment group.3. Performance status score, serum CEA level and treating ways at BM can be used as independent prognostic factors of brain metastases from breast cancer. Patients may live longer with performance status score0～1and CEA expressing level under5ng/ml. Active treatment can improve survival.