B4
Prognosis of brain metastasis in breast cancer patients, with respect to receptor status
Ramachandran Venkitaraman1, Tito Joseph2, Amandeep Dhadda2, Amulya Chaturvedi2, Sunil Upadhyay2
1Ipswich Hospital, East Anglia, UK, 2Queen's Centre for Oncology and Hematology, Hull and East Yorkshire NHS, UK
Background
Brain metastasis in patients with breast cancer is a clinical dilemma with few effective therapeutic options. There is a compelling clinical need to identify patients who are at high risk of developing this disastrous event, so that early detection and early treatment could be considered.
Aim
To characterise the receptor profile (ER, PR and HER2) of patients with brain metastasis from breast cancer. To assess the prognosis of patients with brain metastasis with respect to receptor status, focussing on patients with triple negative breast cancer.
Method
62 consecutive patients with brain metastasis from 2003 to 2008 were included in this retrospective study. The receptor status was assessed and compared to that of a control population of 631 breast cancer patients diagnosed during the same period. The survival of patients with triple negative disease was compared to other subsets of patients with brain metastasis.
Results
17 (27.4 %) of the 62 patients with brain metastasis had triple negative
breast cancer, compared to 104 (16.48 %) of the 631 control patients (p=0.047).
The proportion of patients who were ER negative (48.4 % Vs 24.2 %; p=0.001) and
HER2 positive (40 % Vs 14 %; p=0.001) was also higher in the study population.
Patients with triple negative tumours had a shorter overall survival (3.0 years
Vs 4.4 years; p= 0.041) compared to other patients. These patients had a
shorter time to development of brain metastasis after diagnosis, though not
statistically significant (2.3 years Vs 3.9 years; p= 0.107). Patients with
triple negative breast cancer had shorter survival after the development of
brain metastasis, compared to patients with receptor positive cancer (2.4
months Vs 6.2 months; p= 0.0086).
Conclusion
Patients with triple negative breast cancer are at a high risk of developing brain metastasis and have a poor survival. There may be case for screening for brain metastasis and even prophylactic treatment in this subset of patients.
