Brain metastases as site of first and isolated recurrence of breast cancer: the role of systemic therapy after local treatment
The role of systemic treatment was assessed after local therapy for breast cancer patients who developed central nervous system (CNS) metastases as a first and isolated recurrence. Subjects were 128 breast cancer patients with brain metastases as the first and isolated site of recurrence that were selected from 673 consecutive breast cancer patients with brain metastases treated at the same institution. Median survival from brain metastases in patients with and without systemic treatment after local therapy was respectively 15 and 4 months (p < 0.001). In patients with a Karnofsky Performance Status ≥70 and those <70, survival was respectively 16 and 5.5 months (p < 0.001). The median survival from brain metastasis in patients with solitary brain metastasis, with and without systemic treatment after local therapy, was respectively 22 and 7 months (p = 0.003). Cox multivariate analysis demonstrated that good performance status, solitary brain metastasis and systemic therapy undertaken after local treatment were factors which prolonged survival. However patient survival was adversely affected by those having leptomeningeal metastasis associated with brain parenchymal lesions. Systemic therapy, undertaken after local treatment improved survival in those patients with breast cancer and brain metastases as the site of first and isolated recurrence. Further study is required in order to fully establish the role of systemic treatment for this patient group.
KeywordsBreast cancer Brain metastases First recurrence Solitary brain metastasis Systemic treatment
The author would like to acknowledge our team of medical oncologists from The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland: Tadeusz Pienkowski, Izabela Lemańska, Agnieszka Jagiełło-Gruszfeld, Renata Sienkiewicz-Kozłowska, Elżbieta Brewczynska, Ewa Glinka-Małasnicka, Ewa Szombara, Katarzyna Pogoda, Roman Dubiański, Anna Górniak for undertaking the systemic patient treatment.
Compliance with ethical standards
There are no financial disclosures from the author.
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