Online citations, reference lists, and bibliographies.
← Back to Search

Brain Metastasis In Patients With Metastatic Breast Cancer In The Real World: A Single-institution, Retrospective Review Of 12-year Follow-up

S. Matsuo, J. Watanabe, K. Mitsuya, Nakamasa Hayashi, Yoko Nakasu, M. Hayashi
Published 2017 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
PurposeThe data of 589 metastatic breast cancer (MBC) patients in a single institution were reviewed to determine the outcomes of patients with brain metastasis (BM) and assess the efficacy of BM screening.MethodsThe patients with BM among the 589 MBC patients who underwent treatment at Shizuoka Cancer Center (Shizuoka, Japan) from 09/2002 to 03/2014 were retrospectively analyzed.ResultsDuring the study period, BM developed in 187 (31.7%) patients. The tumor subtypes were as follows: luminal (hormone receptor [HR]+, HER2−), 44.9%; luminal-HER2 (HR+, HER2+), 14.9%; HER2 (HR−, HER2+), 21.3%; and triple-negative (TN), 16.0%. BM was detected in 48.6% of the patients by screening MRI. While 137 of 187 patients underwent local therapy, whole-brain irradiation was the most frequently applied therapy (63.5%). The median overall survival from the diagnosis of BM was as follows: luminal, 7.0 months (M); luminal-HER2, 13.3 M; HER2, 17.7 M; TN, 4.2 M. The HER2 status (hazard ratio [HR]: 0.58, 95% confidence interval [CI] 0.38–0.88) and nonprogressive extracranial lesion(s) (HR: 0.45, 95% CI 0.29–0.71) were identified as prognostic factors in a multivariate analysis. When limited to HER2-overexpressed MBC patients, the multivariate analysis revealed that non-progressive extracranial lesion(s) (HR: 0.20, 95% CI 0.088–0.47) and stereotactic irradiation (STI) as an initial treatment (HR: 0.18, 95% CI 0.061–0.56) were prognostic factors.ConclusionsOur retrospective review showed that early detection of BM by screening MRI, followed by STI, improved the prognosis of HER2-overexpressed MBC patients with BM. A further prospective randomized study is needed to confirm our findings.
This paper references
10.1016/S1470-2045(12)70432-1
Lapatinib plus capecitabine in patients with previously untreated brain metastases from HER2-positive metastatic breast cancer (LANDSCAPE): a single-group phase 2 study.
T. Bachelot (2013)
10.1002/cncr.23930
Sites of distant recurrence and clinical outcomes in patients with metastatic triple‐negative breast cancer
N. Lin (2008)
10.1007/s10549-012-2243-x
Brain metastases after breast-conserving therapy and systemic therapy: incidence and characteristics by biologic subtype
N. Arvold (2012)
10.1016/J.YONC.2010.12.003
Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer and Central Nervous System Metastases
J. Thigpen (2011)
10.1007/s11060-008-9578-5
Brain metastases in breast cancer: clinical and pathologic characteristics associated with improvements in survival
M. Melisko (2008)
10.1158/1078-0432.CCR-10-2962
Central Nervous System Metastases in Patients with HER2-Positive Metastatic Breast Cancer: Incidence, Treatment, and Survival in Patients from registHER
A. Brufsky (2011)
10.1634/THEONCOLOGIST.12-7-766
Central nervous system metastases in HER-2 positive metastatic breast cancer patients treated with trastuzumab: incidence, survival, and risk factors.
S. Gori (2007)
10.1016/j.ijrobp.2009.06.030
The effect of early detection of occult brain metastases in HER2-positive breast cancer patients on survival and cause of death.
A. Niwińska (2010)
10.1002/cncr.11436
Central nervous system metastases in women who receive trastuzumab‐based therapy for metastatic breast carcinoma
J. Bendell (2003)
10.1093/annonc/mdp407
Breast cancer brain metastases: differences in survival depending on biological subtype, RPA RTOG prognostic class and systemic treatment after whole-brain radiotherapy (WBRT).
A. Niwińska (2010)
10.1007/s10549-014-3237-7
Prognostic factors of HER2-positive breast cancer patients who develop brain metastasis: a multicenter retrospective analysis
N. Hayashi (2014)
10.1007/s11060-013-1175-6
Breast cancer and leptomeningeal disease (LMD): hormone receptor status influences time to development of LMD and survival from LMD diagnosis
S. Yust-Katz (2013)
The characterization of novel, dual ErbB-2/EGFR, tyrosine kinase inhibitors: potential therapy for cancer.
D. W. Rusnak (2001)
10.1200/JCO.2009.25.9820
Metastatic behavior of breast cancer subtypes.
H. Kennecke (2010)
10.3171/2010.8.GKS10932
Gamma Knife surgery for metastatic brain tumors from primary breast cancer: treatment indication based on number of tumors and breast cancer phenotype.
S. Matsunaga (2010)
10.1093/annonc/mdu486
Trastuzumab emtansine (T-DM1) versus lapatinib plus capecitabine in patients with HER2-positive metastatic breast cancer and central nervous system metastases: a retrospective, exploratory analysis in EMILIA†
I. Krop (2015)
10.1016/j.ijrobp.2011.02.027
Effect of tumor subtype on survival and the graded prognostic assessment for patients with breast cancer and brain metastases.
P. Sperduto (2012)
10.1016/S1470-2045(14)70061-0
Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study.
M. Yamamoto (2014)
10.1016/S1470-2045(09)70263-3
Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial.
Eric L. Chang (2009)
10.1016/j.prro.2011.12.004
Radiotherapeutic and surgical management for newly diagnosed brain metastasis(es): An American Society for Radiation Oncology evidence-based guideline
M. Tsao (2012)
10.1200/JCO.2014.32.15_SUPPL.2001
Correlation of molecular subtypes with survival in AVAglio (bevacizumab [Bv] and radiotherapy [RT] and temozolomide [T] for newly diagnosed glioblastoma [GB]).
H. Phillips (2014)
10.1007/S00268-005-1100-Z
Randomized controlled trial.
A. Sanabria (2005)
10.1016/j.breast.2013.05.011
Prognostic factors of brain metastases from breast cancer: impact of targeted therapies.
A. Braccini (2013)
10.1200/JCO.2004.12.149
Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System.
J. Barnholtz-Sloan (2004)
10.1200/JCO.2010.30.1655
Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study.
M. Kocher (2011)
Sites of distant recurrence and clinical outcome in patients with metastatic triple - negative breast
NU Lin (2008)
10.1007/s10549-014-3090-8
Treatment outcomes and prognostic factors for patients with brain metastases from breast cancer of each subtype: a multicenter retrospective analysis
N. Niikura (2014)
Central nervous system metastases in women who receive trastuzumab - based therapy for metastatic breast
AM Brufsky (2011)
10.1093/annonc/mdu133
Incidence of central nervous system metastases in patients with HER2-positive metastatic breast cancer treated with pertuzumab, trastuzumab, and docetaxel: results from the randomized phase III study CLEOPATRA
S. Swain (2014)
10.1016/j.breast.2012.10.009
Implication of breast cancer phenotype for patients with leptomeningeal carcinomatosis.
D. Torrejon (2013)
10.1200/JCO.2011.29.15_SUPPL.1073
Breast cancer carcinomatous meningitis: Differences in survival depending on biological subtype, performance status, and treatment methods.
A. Niwińska (2011)
10.1200/JCO.2006.07.0250
Prognostic significance of human epidermal growth factor receptor positivity for the development of brain metastasis after newly diagnosed breast cancer.
Z. Gabos (2006)
10.1093/annonc/mdq232
Survival of breast cancer patients with meningeal carcinomatosis.
H. Gauthier (2010)
10.1200/JCO.2011.41.0639
A European Organisation for Research and Treatment of Cancer phase III trial of adjuvant whole-brain radiotherapy versus observation in patients with one to three brain metastases from solid tumors after surgical resection or radiosurgery: quality-of-life results.
R. Soffietti (2013)
10.1200/JCO.2004.01.175
CNS metastases in breast cancer.
N. Lin (2004)
10.5858/arpa.2013-0953-SA
Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update.
A. Wolff (2014)
10.3171/2010.8.JNS10461
Stereotactic radiosurgery as primary and salvage treatment for brain metastases from breast cancer. Clinical article.
D. Kondziolka (2011)
10.1093/ANNONC/MDG300
Occult central nervous system involvement in patients with metastatic breast cancer: prevalence, predictive factors and impact on overall survival.
K. Miller (2003)
10.1002/cncr.23468
Survival in patients with brain metastases from breast cancer
A. Eichler (2008)
10.1093/JNCI/87.1.34
Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases.
E. Alexander (1995)
10.1016/J.IJROBP.2007.03.048
Neurocognitive function of patients with brain metastasis who received either whole brain radiotherapy plus stereotactic radiosurgery or radiosurgery alone.
H. Aoyama (2007)
10.1007/s11060-013-1257-5
Breast cancer brain metastases responding to primary systemic therapy with T-DM1
R. Bartsch (2013)
10.1016/j.ijrobp.2017.04.037
A Multi-institutional Prospective Observational Study of Stereotactic Radiosurgery for Patients With Multiple Brain Metastases (JLGK0901 Study Update): Irradiation-related Complications and Long-term Maintenance of Mini-Mental State Examination Scores.
M. Yamamoto (2017)
10.1007/s10549-007-9885-0
A phase III randomized comparison of lapatinib plus capecitabine versus capecitabine alone in women with advanced breast cancer that has progressed on trastuzumab: updated efficacy and biomarker analyses
D. Cameron (2007)
Central nervous system metastases in women who receive trastuzumabbased therapy for metastatic breast cancer
JC Bendell (2003)
10.1158/1078-0432.CCR-06-2478
Brain Metastases: The HER2 Paradigm
N. Lin (2007)
10.1016/J.BREASTDIS.2015.07.019
Recommendations on Disease Management for Patients With Advanced Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer and Brain Metastases: American Society of Clinical Oncology Clinical Practice Guideline
M. Edson (2015)



This paper is referenced by
Shizuoka Cancer Center
(2020)
10.4103/sni.sni_228_17
Retrospective study of 229 surgically treated patients with brain metastases: Prognostic factors, outcome and comparison of recursive partitioning analysis and diagnosis-specific graded prognostic assessment
Mirza Pojskic (2017)
10.2147/CMAR.S252801
Breast Cancer Brain Metastasis: The Potential Role of MRI Beyond Current Clinical Applications
A. Hadjipanteli (2020)
10.1016/j.jocn.2019.01.003
Hyperosmotic intraventricular drug delivery of DV1 in the management of intracranial metastatic breast cancer in a mouse model
S. Krishnamurthy (2019)
10.1186/s12885-020-07114-7
Sterile, abscess-like cerebral lesion during trastuzumab therapy after HER2 status switch in a triple negative breast cancer patient: a case report and literature review
T. Mezei (2020)
10.1021/acschemneuro.7b00271
Glycosylation Changes in Brain Cancer.
L. Veillon (2018)
10.1007/s11060-018-2805-9
Hormone receptors status: a strong determinant of the kinetics of brain metastases occurrence compared with HER2 status in breast cancer
A. Darlix (2018)
10.1186/s13058-018-1014-y
A phase II clinical trial of the Aurora and angiogenic kinase inhibitor ENMD-2076 for previously treated, advanced, or metastatic triple-negative breast cancer
J. Diamond (2018)
10.1007/s11060-017-2549-y
Breast cancer subtype and stage are prognostic of time from breast cancer diagnosis to brain metastasis development
A. Saraf (2017)
10.1038/s41416-019-0619-y
Impact of breast cancer molecular subtypes on the incidence, kinetics and prognosis of central nervous system metastases in a large multicentre real-life cohort
A. Darlix (2019)
10.1111/tbj.13230
Treatment response as predictor for brain metastasis in triple negative breast cancer: A score‐based model
P. Gabani (2019)
10.1016/j.clineuro.2020.106150
Brain metastases from breast cancer
Joana Santos (2020)
10.1007/s00330-018-5448-5
Imaging biomarkers from multiparametric magnetic resonance imaging are associated with survival outcomes in patients with brain metastases from breast cancer
Bang-Bin Chen (2018)
10.1158/1535-7163.MCT-19-0461
Identification of ALDH1A3 as a Viable Therapeutic Target in Breast Cancer Metastasis–Initiating Cells
D. Yamashita (2020)
Semantic Scholar Logo Some data provided by SemanticScholar