Skip to main content
SpringerLink
Log in

Brain metastases in breast cancer; natural history, prognostic factors and outcome

  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Summary

One hundred and thirty seven breast cancer patients with CT scan documented brain metastasis (BM) were reviewed. Occurrence of brain as first site of relapse was associated with adjuvant systemic therapy of the primary tumor. Multivariate analysis showed significantly longer survival in patients without manifest systemic disease, in patients with a solitary BM, in those with neurologic symptoms present for more than 4 weeks prior to diagnosis, and in those treated with chemotherapy after diagnosis. When controlling for prognostic factors no significant difference in survival was found between surgery and radiotherapy (RT) as treatment of a solitary lesion. Tumor size, tumor necrosis and mass effect had no demonstrable influence on survival. Overall median survival was 16 weeks and 19% survived one year. Neurologic disease was the cause of death or a major contributing factor to it in 68% of the patients, indicating the need for improvement of the treatment of BM itself. These results warrant further studies on the value of surgery, RT and chemotherapy in solitary as well as multiple BM from breast carcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Posner JB, Chernik NL: Intracranial metastases from systemic cancer. Adv Neurol 19: 579–592, 1978

    Google Scholar 

  2. Tsukada Y, Fouad A, Pickren JW, Lane WW: Central nervous system metastasis from breast carcinoma: Autopsy Study. Cancer 52: 2349–2354, 1983

    Google Scholar 

  3. Lee Y-TN: Patterns of metastasis and natural courses of breast carcinoma. Cancer Metast Rev 4:153–172, 1985

    Google Scholar 

  4. Di Stefano A, Yap HY, Hortobagyi GN, Blumenschein GR: The natural history of breast cancer patients with brain metastases. Cancer 44:1913–1918, 1979

    Google Scholar 

  5. Markesbery WR, Brooks WH, Gupta GD, Young AB: Treatment for patients with cerebral metastases. Arch Neurol 35: 754–756, 1978

    Google Scholar 

  6. West J, Maor M: Intracranial metastases, behavioral patterns related to primary site and results of treatment by whole brain irradiation. Int J Radiation Oncol Biol Phys 6: 11–15, 1980

    Google Scholar 

  7. Cairncross JG, Kim JH, Posner JB: Radiation therapy for brain metastases. Ann Neurol 7: 529–541, 1980

    Google Scholar 

  8. Hoskin PJ, Crow J, Ford HT: The influence of extent and local management on the outcome of radiotherapy for brain metastases. Int J Radiation Oncol Biol Phys 19:111–115, 1990

    Google Scholar 

  9. Patchell RA, Cirrincione C, Thaler HT, Galicich JH, Kim J, Posner JB: Single brain metastases: Surgery plus radiation or radiation alone. Neurology 36: 447–453, 1986

    Google Scholar 

  10. Posner JB, Shapiro WR: Brain tumor. Current status of treatment and its complications. Arch Neurol 32: 781–784, 1975

    Google Scholar 

  11. Borgelt B, Gelder R, Kramer S, Brady LW, Chang CH, Davis LW, Perez CA, Hendrickson FR: The palliation of brain metastases: final results of the first two studies by the radiation therapy oncology group. Int J Radiation Oncol Biol Phys 6: 1–8, 1980

    Google Scholar 

  12. Cairncross JG, Chernik NL, Kim J, Posner JB: Sterilization of cerebral metastases by radiation therapy. Neurology 29: 1195–1202, 1979

    Google Scholar 

  13. Gelber RD, Larson M, Borgelt BB, Kramer S: Equivalence of radiation schedules for palliative treatment of brain metastasis in patients with favorable prognosis. Cancer 48: 1749–1753, 1981

    Google Scholar 

  14. Eyre HL, Ohlsen JD, Frank J, Lo Buglio AF, Mc Cracken JD, Weatherall TJ, Mansfield CM: Randomized trial of radiotherapy versus radiotherapy plus metronidazole for the treatment of metastatic cancer to the brain. J Neuro-Oncol 2: 325–330, 1984

    Google Scholar 

  15. De Angelis LM, Currie VE, Kim J, Krol G, Hehir MA, Farag FM, Young CW, Posner JB: The combined use of radiation therapy and lonidamine in the treatment of brain metastases. J Neuro-Oncol 7: 241–247, 1989

    Google Scholar 

  16. Kurtz JM, Gelber R, Brady LW, Carella RJ, Cooper JS: The palliation of brain metastases in a favorable patient population: A randomized clinical trial by the radiation therapy oncology group. Int J Radiat Oncol Biol Phys 7: 891–895, 1981

    Google Scholar 

  17. Zimm S, Wampler GL, Stablein D, Hazra T, Young HF: Intracerebral metastases in solid-tumor patients. Natural history and results of treatment. Cancer 48: 384–394, 1981

    Google Scholar 

  18. Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio R, Markesbery WR, Macdonald JS, Young B: A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322: 494–500, 1990

    Google Scholar 

  19. Kristjansen PEG, Hansen HH: Brain metastases from small cell lung cancer treated with combination chemotherapy. Eur J Cancer Clin Oncol 24: 545–549, 1988

    Google Scholar 

  20. Rosner D, Nemoto T, Lane W: Chemotherapy induces regression of brain metastases in breast carcinoma. Cancer 58: 832–839, 1986

    Google Scholar 

  21. Cocconi G, Lottici R, Bisagni G, Bacchi M, Tonato M, Passalacqua R, Bonil C, Belsanti V, Bassi P: Combination therapy with platinum and etoposide of brain metastases from breast carcinoma. Cancer Inv 8: 327–334, 1990

    Google Scholar 

  22. Boogerd W, Dalesio O, Bais EM, Van der Sande JJ: Response of brain metastases from breast cancer to systemic chemotherapy. Cancer 69: 972–980, 1992

    Google Scholar 

  23. Kamby C, Soerensen PS: Characteristics of patients with short and long survivals after detection of intracranial metastases from breast cancer. J Neuro Oncol 6: 37–45, 1988

    Google Scholar 

  24. Cox DR: Regression models and life-tables. JR Stat Soc 34: 187–220, 1972

    Google Scholar 

  25. Van Houwelingen JC, Le Cessie S: Predictive value of statistical models. Stat Med 9:1303–1325, 1990

    Google Scholar 

  26. Hietanen P, Miettinen M, Makinen J: Survival after first recurrence in breast cancer. Eur J Cancer Clin Oncol 22: 913–919, 1986

    Google Scholar 

  27. Clark GW, Sledge GW, Osborne CK, McGuire WL: Survival from first recurrence: relative importance of prognostic factors in 1015 breast cancer patients. J Clin Oncol 5: 55–61, 1987

    Google Scholar 

  28. Paterson AHG, Agarwal M, Lees A, Hanson J, Szafran O: Brain metastases in breast cancer patients receiving adjuvant chemotherapy. Cancer 49: 651–654, 1982

    Google Scholar 

  29. Gercovitch FG, Luna MA, Gottlieb JA: Increased incidence of cerebral metastases in sarcoma patients with prolonged survival from chemotherapy. Cancer 36:1843–1851, 1975

    Google Scholar 

  30. Viadana E, Bross ID, Pickren JW: An autopsy study of some routes of dissemination of cancer of the breast. Br J Cancer 27: 336–340, 1973

    Google Scholar 

  31. Sze G, Milano E, Johnson C, Heier L: Detection of brain metastases: comparison of contrast-enhanced MR with unenhanced MR and enhanced CT. AJNR 11: 785–791, 1990

    Google Scholar 

  32. Shi M, Wallace S, Libshitz HL: Cranial computed tomography of breast carcinoma. J Comput Tomogr 6: 77–88, 1982

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology of the Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, The Netherlands

    W. Boogerd & V. W. Vos

  2. Department of Radiotherapy of the Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, The Netherlands

    A. A. M. Hart & G. Baris

Authors
  1. W. Boogerd
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. W. Vos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. A. M. Hart
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Baris
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boogerd, W., Vos, V.W., Hart, A.A.M. et al. Brain metastases in breast cancer; natural history, prognostic factors and outcome. J Neuro-Oncol 15, 165–174 (1993). https://doi.org/10.1007/BF01053937

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01053937

Key words

Search

Navigation