| Autor: |
Margaret M Kozak, Jamie Karl, Rie von Eyben, Felicia Guo, Paulina Gutkin, Kathleen Horst |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Clinical Breast Cancer. 22:e916-e921 |
| ISSN: |
1526-8209 |
| DOI: |
10.1016/j.clbc.2022.08.002 |
| Popis: |
Patients with metastatic breast cancer may develop brain metastases. Our study identified high-risk patients to refine selection criteria for BM screening approaches.We reviewed breast cancer patients treated with neoadjuvant chemotherapy (NAC) at a single university center between 2005 and 2019.Competing risks analysis was performed with the Fine and Gray model to analyze the cumulative incidence of BM and loco-regional recurrence. Overall survival (OS) and progression-free survival (PFS) were calculated using Kaplan-Meier and log-rank tests. Multivariable analysis was performed with Cox proportional hazards regression to identify factors predictive for development of BM. Statistical significance was determined as a 2-sided P value of.05.In total, 112 patients experienced distant failure (DF) and 49 patients developed BM. Twenty patients with BM (41%) presented with symptoms requiring craniotomy +/- whole brain radiation treatment. Patients with BM were significantly more likely to have local (P.01) and regional (P.01) failure. On multivariable analysis, age40 years (P = .011), presence of lung metastases (P.0001), and residual nodal disease with4 lymph nodes positive after NAC (P = .024) all predicted for increased likelihood of BM. Patients with these criteria had higher likelihoods of having BM (P = .013) and worse PFS (P = .044). On multivariable analysis for OS, presence of lung metastases was the most significant predictor of poor outcome (P.0001).We propose a study of screening brain MRI for young (40 years) patients with breast cancer receiving NAC and patients who develop metastatic disease post-NAC, especially those with lung involvement. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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