Background: Incidence of brain metastases (BM) from breast cancer (BC) is increasing. However, prognostic evaluation and treatment strategies are still a matter of debate.
Aim: To describe the clinical outcome of BM from BC treated by neurosurgical resection and to identify the actual prognostic factors in this specific population.
Patients and methods: We retrospectively reviewed all patients (n=49) with BM from BC treated at our institutions by surgical resection, between December 2001 and July 2011. Patient, tumor and treatment characteristics were recorded.
Results: Median cerebral progression-free survival (CPFS) was 11.3 months (95% Confidence Interval (CI)=6.0-16.6 months) and median overall survival (OS) was 19.4 months (95% CI=16.1-22.7 months). By multivariate analyses, altered Mini Mental Status (MMS) (CPFS: p=0.012, OS: p=0.009), multiple systemic metastases (CPFS: p=0.020, OS: p<0.001) and absence of post-operative chemotherapy (CPFS: p=0.013, OS: p=0.006) had independent adverse prognostic values. Hormonal receptors, Human epidermal growth factor-2 (HER2) and molecular subtype were not significantly correlated to survival.
Conclusion: Surgical resection is an effective treatment in selected patients with BM from BC. MMS, number of systemic metastases and the use of postoperative systemic treatment are associated with better outcome.
Keywords: Brain metastases; breast cancer; prognostic factors; surgical resection.