| BackgroundAll around the world, breast cancer is the first leading type of all cancers and the fifth leading causes of death in all types of cancers in female. Breast cancer has become the biggest threat to women’s health. About 25% of postoperative patients will develop metastatic or recurrent breast cancer and brain metastases accounts for 15% in advanced breast cancer. The average survival time of brain metastases from breast cancer is only one or two months if not treated promptly, However, the overall survival of brain metastases is less than two years after treatments. With the development of systemic therapy for the treatment of breast cancer, the incidence of brain metastases from breast cancer is gradually increasing. Treatment with surgery, stereotactic radio-surgery, whole brain radiotherapy (WBRT) chemotherapy, hormone therapy and targeted therapy have been widely used for breast cancer. Many clinic factors influence development and prognosis of brain metastases from breast cancer. In the current study, we aimed to analysis the clinical characteristics, and the correlation of the clinicopathological factors and breast cancer progression, and studied its impact on survival of patients with brain metastases by retrospective survey.MethodsWe conducted a retrospective analysis of brain metastases from breast cancer managed at the Second Affiliated Hospital of Zhejiang University between January 2000 to December 2014 and these patients were followed to March 22,2016. The clinicopathological data of these patients were gathered. They might have important impacts on time to development of brain metastases, brain metastases-free survival (BMFS), overall survival of brain metastases (BMOS). Univariate analysis was used By SPSS 20.0 software package.Results:1. The median TDBM was 39 ± 3.84 months (95% CI:31.48-46.52) (ranging from 0 to 204 months), and median BMFS was 1 ± 3.41 months (95% CI:0～7.69) (ranging from 0 to 73 months). TDBM was influenced by TNM-staging, tumor characteristics (including estrogen receptor, progesterone receptor, HER-2). while, tumor characteristics had effects on BMFS.2. To the end of the follow-up, the median survival time of all patients was 14 ± 2.74 months (95%CI:8.63-19.37) (ranging from 1 to 128 months). The one-and two-year survival rates of the patients were 55.9% and 32.2% respectively. Univariate analysis showed some statistically significant factors such as age and performance status score when brain metastases (BM) occurred.3. Treating ways affected overall survival of brain metastases from breast cancer. Patients who only accepted monotherapy had a median4. survival of 4 months (95% CI:0-9.68). The combined treatment group and the surgical resection group had a median survival time of 22 months (95% CI:11.82-32.18), 2 months (95% CI:0-4.07), respectively. Treatment type of brain metastasis effect the survival time (p< 0.05), with statistical significance.Conclusions1. Time to development of brain metastases was influenced by TNM-staging and tumor genotype in northern area of Zhejiang province.2. Patients who accepted combined treatment have a longer survival time compared with the monotherapy group. The systemic treatment group have a better survival compared with the surgical resection group.3. Performance status score, treating ways at BM can be used as independent prognostic factors of brain metastases from breast cancer. Patients may live longer with performance status score 0-1 and combined treatment. |
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