Brain Metastases From Breast Cancer

Abstract

Abstract BACKGROUND: Breast cancer (BC) is one of the commonest causes of brain metastases (BM): approximately 10-16% of patients diagnosed with metastatic BC will eventually develop BM during the course of their disease, however, certain subtypes have a higher risk of this event. The aim of this analysis was therefore to evaluate the prognosis, the pattern of BM and imaging features according to different BC subtypes. PATIENTS AND METHODS: We retrospectively reviewed the case records of patients with BC and evidence of BM from the database of IPO Porto between 2014 to 2018. The data obtained were statistically analysed. RESULTS: We analysed 147 patients with BM from breast cancer. The triple-negative subtype had the shortest survival time after BM (6.88 vs 15.41 months; p < .001), besides a short period of time between BC and BM (37.41 vs 66.57 months; p =.008). HER2 overexpressing tumours had the longest survival time after BM (18.06 vs 11.57 months; p < .01). The estrogen receptor-positive group had the greatest interval between initial BC diagnosis and diagnosis of BM (76.01 vs 36.98 months; p <.001). Larger lesions showed a heterogeneous contrast enhancement (27.87 vs 15.42mm; p <.001) and were heterogeneous in T2 sequences (31.18 vs 20.49 mm; p =.001); a hyposignal on T2* was also associated with larger lesions (30.93 vs 23.07mm; p =.001). We noticed that the hippocampus is rarely affected by metastatic lesions. CONCLUSIONS: Based on the BC subtype it is possible to make a prediction about the distribution of BM and the prognosis. These data support further research concerning prevention, early detection, and treatment of BM from BC.