Retrospective Analysis of Risk Factors for Central Nervous System Metastases in Operable Breast Cancer: Effects of Biologic Subtype and Ki67 Overexpression on Survival
- 11 December 2012
- journal article
- Published by S. Karger AG in Oncology
- Vol. 84 (3), 135-140
- https://doi.org/10.1159/000345321
Abstract
Identifying factors that predispose patients to central nervous system (CNS) metastases may hasten disease detection and improve treatment outcomes. We reviewed the records of patients who were diagnosed with clinical stage I-III primary breast cancer at the National Cancer Center Hospital East from 2003 to 2005. Cox proportional hazard models were fitted to reveal risk factors for CNS metastases. The median follow-up period after the operation was 53.5 months. Among the 591 identified patients with breast cancer, 76 experienced a relapse. Seventeen patients developed CNS metastases. Multivariate analysis indicated that the triple negative (TN) subtype (hazard ratio = 5.5) and a high Ki67 labeling index (LI; hazard ratio = 3.9) were associated with a higher risk for CNS metastases. At 4 years, the TN subtype was associated with significantly worse overall and disease-free survival rates and a higher cumulative incidence of CNS metastases compared with hormone receptor-positive/ human epidermal growth factor receptor-2-negative tumors. Breast cancers with a Ki67 LI ≥30% were also associated with lower overall and disease-free survival rates and a higher cumulative incidence of CNS metastases compared with cancers with a Ki67 LI <30%. TN or Ki67-overexpressing breast cancer produced earlier CNS metastases and lower disease-free and overall survival rates.Keywords
This publication has 23 references indexed in Scilit:
- Survival among women with triple receptor-negative breast cancer and brain metastasesAnnals of Oncology, 2009
- Cerebral metastases (CM) in breast cancer (BC) with focus on triple-negative tumorsJournal of Clinical Oncology, 2008
- Clinicopathologic characteristics and prognostic factors in 420 metastatic breast cancer patients with central nervous system metastasisCancer, 2007
- Chemotherapy Delivery Issues in Central Nervous System Malignancy: A Reality CheckJournal of Clinical Oncology, 2007
- Brain Metastases of Breast CancerBreast Disease, 2007
- Primary breast cancer phenotypes associated with propensity for central nervous system metastasesCancer, 2006
- Identifying breast cancer patients at risk for Central Nervous System (CNS) metastases in trials of the International Breast Cancer Study Group (IBCSG)Annals of Oncology, 2006
- CNS Metastases in Breast CancerJournal of Clinical Oncology, 2004
- Incidence Proportions of Brain Metastases in Patients Diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance SystemJournal of Clinical Oncology, 2004
- Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanomaCancer, 2002