Survival among women with triple receptor-negative breast cancer and brain metastases

Abstract

Background: The purpose of this study was to determine the incidence of and survival following brain metastases among women with triple receptor-negative breast cancer.

Patients and methods: In all, 679 patients with nonmetastatic triple receptor-negative breast cancer diagnosed from 1980 to 2006 were identified. Cumulative incidence of brain metastases was computed. Cox proportional hazards models were fitted to explore factors that predict for development of brain metastases. Survival was computed using the Kaplan-Meier product limit method.

Results: Median follow-up was 26.9 months. In all, 42 (6.2%) patients developed brain metastases with a cumulative incidence at 2 and 5 years of 5.6% [95% confidence interval (CI) 3.8% to 7.9%] and 9.6% (95% CI 6.8% to 13%), respectively. A total of 24 (3.5%) patients developed brain metastases as the first site of recurrence with cumulative incidence at 2 and 5 years of 2.0% (95% CI 2.6% to 6.0%) and 4.9% (95% CI 3.2% to 7.0%), respectively. In the multivariable model, no specific factor was observed to be significantly associated with time to brain metastases. Median survival for all patients who developed brain metastases and those who developed brain metastases as the first site of recurrence was 2.9 months (95% CI 2.0-7.6 months) and 5.8 months (95% CI 1.7-11.0 months), respectively.

Conclusion: In this single-institutional study, patients with nonmetastatic triple receptor-negative breast tumors have a high early incidence of brain metastases associated with poor survival and maybe an ideal cohort to target brain metastases preventive strategies.

Figure 1.

Kaplan–Meier plots illustrating survival and 95% confidence intervals among all 42 patients who developed brain metastases. Median survival for this group following a diagnosis of brain metastases was 2.9 months (95% confidence interval 2.0–7.6 months).

Figure 2.

Kaplan–Meier plots illustrating survival among patients who developed brain metastases as the first site of recurrence and those who did not. Median survival among those who did and did not develop brain metastases as a first site of recurrence was 5.8 months [95% confidence interval (CI) 1.7–11 months] and 13.0 months (95% CI 11.4–17.6 months), respectively.