Breast Cancer Research and Treatment

, Volume 147, Issue 1, pp 103–112 | Cite as

Treatment outcomes and prognostic factors for patients with brain metastases from breast cancer of each subtype: a multicenter retrospective analysis

  • Naoki NiikuraEmail author
  • Naoki Hayashi
  • Norikazu Masuda
  • Seiki Takashima
  • Rikiya Nakamura
  • Ken-ichi Watanabe
  • Chizuko Kanbayashi
  • Mayumi Ishida
  • Yasuo Hozumi
  • Michiko Tsuneizumi
  • Naoto Kondo
  • Yoichi Naito
  • Yayoi Honda
  • Akira Matsui
  • Tomomi Fujisawa
  • Risa Oshitanai
  • Hiroyuki Yasojima
  • Yutaka Tokuda
  • Shigehira Saji
  • Hiroji Iwata
Clinical trial


To define prognostic factors for breast cancer patients with brain metastases, compare their clinical courses and prognoses according to breast cancer subtypes, and analyze the causes of death in such patients. We retrospectively analyzed 1,466 patients diagnosed with brain metastases between April 1, 2001 and December 31, 2012, from 24 institutions of the Japan Clinical Oncology Group. Overall, 1,256 patients with brain metastases were included. The median overall survival (OS) was 8.7 months (95 % confidence interval [CI] 7.8–9.6 months). Univariate and multivariate analyses revealed that patients diagnosed with brain metastasis within 6 months of metastatic breast cancer diagnoses, asymptomatic brain disease, or HER2-positive/estrogen receptor-positive tumors had increased OS. Median OS after the development of brain metastases was 9.3 months (95 % CI 7.2–11.3) for the luminal type, 16.5 months (95 % CI 11.9–21.1) for the luminal-HER2 type, 11.5 months (95 % CI 9.1–13.8) for the HER2 type, and 4.9 months (95 % CI 3.9–5.9) for the triple-negative type. Luminal-HER2 type patients had significantly longer OS than patients with the luminal type (hazard ratio [HR] = 1.50, P < 0.0001) and triple-negative type (HR = 1.97, P < 0.0001); no significant differences were noted compared to HER2-type patients (HR = 1.19, P = 0.117). The prognosis and clinical course of patients with brain metastasis from breast cancer before and after developing brain metastases vary according to subtype. Focusing on the subtypes of breast cancer can optimize the prevention, early detection, and improved treatment of brain metastases.


Breast cancer Brain metastases Retrospective analysis Subtype 



We would like to thank the following individuals for providing us with data on patients with brain metastases: Yasuyuki Sato, Nagoya Medical Center; Yoshimasa Kosaka, Kitasato University School of Medicine; Tsutomu Iwasa, Kinki University School of Medicine; Hiroyasu Yamashiro, Kure Medical Center/Chugoku Cancer Center; Tadahiko Shien; Okayama University Hospital; Kazuya Miyoshi, NHO Fukuyama Medical Center; Anan Keisei, Kitakyushu Municipal Medical Center, Department of Surgery; Hitoshi Arioka, Yokohama Rosai Hospital; and Maeda Shigeto, National Nagasaki Medical Center. We would also like to thank Editage for providing editorial assistance. This study was supported by the National Cancer Center Research and Development Fund (23-A-17) and Tokai University School of Medicine Research Aid, 2013.


There are no conflicts of interest to declare.

Supplementary material

10549_2014_3090_MOESM1_ESM.doc (60 kb)
Supplementary material 1 (DOC 60 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Naoki Niikura
    • 1
    • 2
    Email author
  • Naoki Hayashi
    • 3
  • Norikazu Masuda
    • 4
  • Seiki Takashima
    • 5
  • Rikiya Nakamura
    • 6
  • Ken-ichi Watanabe
    • 7
  • Chizuko Kanbayashi
    • 8
  • Mayumi Ishida
    • 9
  • Yasuo Hozumi
    • 10
  • Michiko Tsuneizumi
    • 11
  • Naoto Kondo
    • 12
  • Yoichi Naito
    • 13
    • 14
  • Yayoi Honda
    • 15
  • Akira Matsui
    • 16
  • Tomomi Fujisawa
    • 17
  • Risa Oshitanai
    • 1
  • Hiroyuki Yasojima
    • 4
  • Yutaka Tokuda
    • 1
  • Shigehira Saji
    • 2
  • Hiroji Iwata
    • 12
  1. 1.Department of Breast and Endocrine SurgeryTokai University School of MedicineIseharaJapan
  2. 2.Department of Target Therapy OncologyKyoto University Graduate School of MedicineKyotoJapan
  3. 3.Department of Breast Surgical OncologySt. Luke’s International HospitalTokyoJapan
  4. 4.Department of Surgery, Breast OncologyNational Hospital Organization Osaka National HospitalOsakaJapan
  5. 5.Department of Breast OncologyNational Hospital Organization Shikoku Cancer CenterMatsuyamaJapan
  6. 6.Chiba Cancer Center HospitalChibaJapan
  7. 7.Department of Breast SurgeryHokkaido Cancer CenterSapporoJapan
  8. 8.Department of Breast OncologyNiigata Cancer Center HospitalNiigataJapan
  9. 9.Department of Breast OncologyNational Kyushu Cancer CenterFukuokaJapan
  10. 10.Department of Breast OncologyJichi Medical UniversityShimotsukeJapan
  11. 11.Department of Breast SurgeryShizuoka General HospitalShizuokaJapan
  12. 12.Department of Breast OncologyAichi Cancer Center HospitalNagoyaJapan
  13. 13.Department of Experimental TherapeuticsNational Cancer Center Exploratory Oncology Research and Clinical Trial CenterTokyoJapan
  14. 14.Department of Breast and Medical OncologyNational Cancer Center Hospital EastChibaJapan
  15. 15.Division of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Disease CenterKomagome HospitalTokyoJapan
  16. 16.Department of Surgery, National Hospital OrganizationTokyo Medical CenterTokyoJapan
  17. 17.Gunma Prefectural Cancer CenterOtaJapan

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