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Pathological Complete Response as Outcome Modifier in Breast Cancer Patients and Brain Metastasis

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Abstract

Breast cancer with brain metastases (BCBM) has dreadful outcomes. Various factors influencing outcomes are age, receptors status, number of distant metastases, performance status, leptomeningeal metastasis, chemotherapies, and whole brain radiation dose. This study aimed to find outcome-modifying factors in BCBM. Clinical, demographic, subtype, and pathological response of primary brain imaging characteristics of BCBM patients were correlated with brain metastasis-free interval and survival after brain metastasis was studied from January 2020 to March 2022. Triple-negative breast cancer (TNBC) patients had the earliest presentation for brain metastases (mean 45.4 years) vs luminal B (mean 57.93 years). Both brain metastasis-free interval (BMFI) and brain metastasis overall survival (BMOS) were maximum in HER2-positive subtype (mean 22.8 and 11.55 months) and least in TNBC patients (mean 9.8 and 2.12 months), respectively. Low-graded prognosis assessment (GPA) score and leptomeningeal metastasis were associated with the worst outcomes. BMFI and BMOS in patients with pathological complete response (PCR) were at 28.5 and 15.1 months, in partial response were 18.5 and 7.66 months, and with stable or progressive disease were 11 and 1.36 months, respectively. In the present study, PCR was the only modifiable parameter that changed breast cancer outcomes with brain metastasis and leptomeningeal metastasis was associated with the worst outcomes. Our study favors that PCR has prognostic importance.

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References

  1. Patanaphan V, Salazar OM, Risco R (1988) Breast cancer: metastatic patterns and their prognosis. South Med J 81(9):1109–1112

    Article  CAS  PubMed  Google Scholar 

  2. Bailleux C, Eberst L, Bachelot T (2021) Treatment strategies for breast cancer brain metastases. Br J Cancer 124(1):142–155. https://doi.org/10.1038/s41416-020-01175-y

  3. Bai B, Yuan ZY, Liu DG, Teng XY, Wang SS (2010) Clinical features and survival analysis of different subtypes of patients with breast cancer brain metastases. Chin J Cancer 29(4):413–9. https://doi.org/10.5732/cjc.009.10643

  4. Batool A, Kasi A (2022) Leptomeningeal carcinomatosis. StatPearls. Treasure Island (FL), StatPearls Publishing

    Google Scholar 

  5. Cortazar P, Zhang L, Untch M et al (2014) Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 384(9938):164–172

    Article  PubMed  Google Scholar 

  6. Li J, Chen S, Chen C, Di G, Liu G, Wu J, Shao Z (2017) Pathological complete response as a surrogate for relapse-free survival in patients with triple negative breast cancer after neoadjuvant chemotherapy. Oncotarget 8(11):18399–18408. https://doi.org/10.18632/oncotarget.9369

    Article  PubMed  Google Scholar 

  7. Niikura N, Saji S, Tokuda Y, Iwata H (2014) Brain metastases in breast cancer. Jpn J ClinOncol 44(12):1133–1140. https://doi.org/10.1093/jjco/hyu156

    Article  Google Scholar 

  8. Riecke K, Müller V, Weide R, Schmidt M, Park-Simon TW, Möbus V, Mundhenke C, Polasik A, Lübbe K, Hesse T, Laakmann E, Thill M, Fasching PA, Denkert C, Fehm T, Nekljudova V, Rey J, Loibl S, Witzel I (2021) Predicting prognosis of breast cancer patients with brain metastases in the BMBC registry-comparison of three different GPA prognostic scores Cancers (Basel) 13(4):844. https://doi.org/10.3390/cancers13040844

    Article  CAS  PubMed  Google Scholar 

  9. Rostami R, Mittal S, Rostami P, Tavassoli F, Jabbari B (2016) Brain metastasis in breast cancer: a comprehensive literature review. J Neurooncol 127(3):407–414. https://doi.org/10.1007/s11060-016-2075-3

    Article  CAS  PubMed  Google Scholar 

  10. Lao C, Elwood M, Kuper-Hommel M, Campbell I, Lawrenson R (2021) Impact of menopausal status on risk of metastatic recurrence of breast cancer. Menopause 28(10):1085–1092. https://doi.org/10.1097/GME.0000000000001817

    Article  PubMed  Google Scholar 

  11. Árkosy P, Tóth J, Béres E, Tóth D, Szivos L, Nagy J, Klekner A, Virga J (2020) Prognosis and treatment outcomes of patients undergoing resection of brain metastases from breast cancer. Anticancer Res 40(3):1759–1770. https://doi.org/10.21873/anticanres.14130

  12. Jung JM, Kim S, Joo J, Shin KH, Gwak HS, Lee SH (2012) Incidence and risk factors for leptomeningeal carcinomatosis in breast cancer patients with parenchymal brain metastases. J Korean Neurosurg Soc 52(3):193–199. https://doi.org/10.3340/jkns.2012.52.3.193

    Article  PubMed  PubMed Central  Google Scholar 

  13. Suteu P, Fekete Z, Todor N, Nagy V (2019) Survival and quality of life after whole brain radiotherapy with 3D conformal boost in the treatment of brain metastases. Med Pharm Rep 92(1):43–51

    PubMed  PubMed Central  Google Scholar 

  14. Izutsu N, Kinoshita M, Ozaki T, Sakai M, Nakanishi K, Nakayama T, Tamaki Y, Kishima H (2021) Cerebellar preference of luminal A and B type and basal ganglial preference of HER2-positive type breast cancer-derived brain metastases. Mol Clin Oncol 15(3):175. https://doi.org/10.3892/mco.2021.2337

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

All the breast cancer with brain metastasis patients who participated in the study

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Authors and Affiliations

  1. Department of Endocrine Surgery, Shatabdi Hospital, Phase II, King George’s Medical University, Shamina Road, Lucknow, Uttar Pradesh, India

    Upander Kumar, Anand Kumar Mishra, Kul Ranjan Singh, Nancy Raja, Ganesh Bhat, Rizhin Sooraj & Pooja Ramakant

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  1. Upander Kumar
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  2. Anand Kumar Mishra
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Correspondence to Anand Kumar Mishra.

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Kumar, U., Mishra, A.K., Singh, K.R. et al. Pathological Complete Response as Outcome Modifier in Breast Cancer Patients and Brain Metastasis. Indian J Surg Oncol 15, 332–340 (2024). https://doi.org/10.1007/s13193-024-01898-x

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