Defining survival for patients with breast cancer with brain metastases.

Abstract

258 Background: Brain metastases account for 100,000 to 170,000 cases per year in the U.S, the bulk being from breast and lung primaries. About 10-15% of breast cancer patients develop brain metastases and historically, their survival has been poor. Introduction of novel chemotherapeutic and biologic agents and newer radiation techniques in the past decade has led to better control of systemic disease raising the possibility of increasing incidence of brain metastases as well as better control of CNS disease. The aim of this study was to determine the survival of breast cancer patients with brain metastases in our practice in the last 10 years. Methods: This study was a retrospective chart analysis and we analyzed the charts of 18 patients with breast cancer who had developed brain metastases. The parameters analyzed included patient age at diagnosis of breast cancer and at development of brain metastases, receptor status and various treatment modalities used to control local as well as Metastatic disease. Results: The median survival time after adjusting for age at diagnosis of breast cancer, age at diagnosis of brain metastases and the number of brain metastases was 55 months. The time to death was analyzed using Cox proportional hazard model, adjusting for age and number of brain metastases. Age at diagnosis of breast cancer was significant with a p-value of 0.007 and the number of brain metastases was not significant with a p-value of 0.55. Using the Log Rank test, median survival for Her2neu positive patients was 71 months and for Her2neu negative patients was 58 months with a non-significant p value of 0.86. Review of treatment modalities revealed that six patients underwent surgical removal of metastases and 12 patients received WBRT. Average number of systemic treatments used was 6.7 including chemotherapeutic, biological and hormonal agents. Conclusions: In our practice, the overall survival of breast cancer patients with brain metastases was found to be 55 months after adjusting for age at diagnosis of breast cancer, age at diagnosis of brain metastases and number of brain metastases. Overall survival did not vary significantly with the number of brain metastases and Her2neu receptor status.