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. 2022 Aug;159(1):53-63.
doi: 10.1007/s11060-022-04043-2. Epub 2022 Jun 7.

Time interval between the diagnosis of breast cancer and brain metastases impacts prognosis after metastasis surgery

Anna Michel  1   2   3   4 , Thiemo Florin Dinger  5   6   7 , Alejandro N Santos  5   6   7 , Daniela Pierscianek  5   6   7 , Marvin Darkwah Oppong  5   6   7 , Yahya Ahmadipour  5   6   7 , Philipp Dammann  5   6   7 , Karsten H Wrede  5   6   7 , Jörg Hense  8   7 , Christoph Pöttgen  9   7 , Antonella Iannaccone  10   7 , Rainer Kimmig  10   7 , Ulrich Sure  5   6   7 , Ramazan Jabbarli  5   6   7
Affiliations

Time interval between the diagnosis of breast cancer and brain metastases impacts prognosis after metastasis surgery

Anna Michel et al. J Neurooncol. 2022 Aug.

Abstract

Purpose: Breast cancer (BC) is the most frequently diagnosed tumor entity in women. Occurring at different time intervals (TI) after BC diagnosis, brain metastases (BM) are associated with poor prognosis. We aimed to identify the risk factors related to and the clinical impact of timing on overall survival (OS) after BM surgery.

Methods: We included 93 female patients who underwent BC BM surgery in our institution (2008-2019). Various clinical, radiographic, and histopathologic markers were analyzed with respect to TI and OS.

Results: The median TI was 45.0 months (range: 9-334.0 months). Fifteen individuals (16.1%) showed late occurrence of BM (TI ≥ 10 years), which was independently related to invasive lobular BC [adjusted odds ratio (aOR) 9.49, 95% confidence interval (CI) 1.47-61.39, p = 0.018] and adjuvant breast radiation (aOR 0.12, 95% CI 0.02-0.67, p = 0.016). Shorter TI (< 5 years, aOR 4.28, 95% CI 1.46-12.53, p = 0.008) was independently associated with postoperative survival and independently associated with the Union for International Cancer Control stage (UICC) III-IV of BC (aOR 4.82, 95% CI 1.10-21.17, p = 0.037), midline brain shift in preoperative imaging (aOR10.35, 95% CI 1.09-98.33, p = 0.042) and identic estrogen receptor status in BM (aOR 4.56, 95% CI 1.35-15.40, p = 0.015).

Conclusions: Several factors seem to influence the period between BC and BM. Occurrence of BM within five years is independently associated with poorer prognosis after BM surgery. Patients with invasive lobular BC and without adjuvant breast radiation are more likely to develop BM after a long progression-free survival necessitating more prolonged cancer aftercare of these individuals.

Keywords: Brain metastasis; Brain metastasis surgery; Breast cancer; Invasive loboluar breast cancer; Time interval.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Scatter plot of the TI distribution in the cohort. BC breast cancer, BM brain metastasis, TI time interval
Fig. 2
Fig. 2
Kaplan Meier curve illustrating the impact of time interval (< 5 years) on OS after BC BM surgery. BC breast cancer, BM brain metastasis, TI time interval, OS overall survival., No number
Fig. 3
Fig. 3
Major differences in BC- and BM-related characteristics between individuals with short (< 5 years) and long (≥ 10 years) TI. BC breast cancer, BM brain metastasis, TI time interval, ER estrogen receptor, UICC Union for international cancer control, *p < 0.05
See this image and copyright information in PMC

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