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CNS metastases in breast cancer patients: prognostic implications of tumor subtype

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Abstract

Development of brain metastases (BM) in breast cancer leads to limited survival. The therapeutical options are limited. There are less data about the risk factors and prognostic importance in BM. Objective is to investigate predictors of central nervous system metastases and outcome after diagnosis of BM according to tumor subtype. Based on medical records, 80 consecutive patients with primary non-metastatic operable breast cancer, treated at Department of Gynecology, University of Tübingen, and who developed BM during follow-up, were retrospectively analyzed. Clinicopathological parameters and their prognostic impact were evaluated. A node involvement (40 %), ER/PR negative (53.75 vs. 61.25 %), triple negative (28.75 %) and HER2+ status (40 %) were associated with BM. BM in breast cancer patients lead to a shortened survival. In cerebral metastatic breast cancer patients with HER2-negative and triple-negative, patients had significant shorter survival after detection of BM compared with HER2-positive and non-triple-negative patients (p = 0.001; p = 0.03). Risk of BM varies significantly by subtype. Understanding the biology of metastases can help categorize patients into prognostically useful categories and tailor treatment regimens for individual patients. Prospective clinical trials would be required for evaluating the potential role of screening for asymptomatic BM and of treatment of triple-negative patients.

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Conflict of interest

All authors state that they have no conflicts of interest.

Ethical standard

The experiments comply with the current laws of our country. For the investigation, there exists a votum of the Ethics Committee (No. 171/2012R).

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Authors and Affiliations

  1. Department of Gynecology, University of Tübingen, Calwer Str. 7, 72070, Tübingen, Germany

    C. Bachmann, S. Schmidt, D. Wallwiener & E. Grischke

  2. Department of Pathology, University of Tübingen, Tübingen, Germany

    A. Staebler & F. Fend

  3. Department of Neuropathology, University of Tübingen, Tübingen, Germany

    J. Schittenhelm

  4. Department of Gynecology, University of Düsseldorf, Düsseldorf, Germany

    T. Fehm

Authors
  1. C. Bachmann
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  2. S. Schmidt
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  3. A. Staebler
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  4. T. Fehm
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  5. F. Fend
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  6. J. Schittenhelm
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  7. D. Wallwiener
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  8. E. Grischke
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Correspondence to C. Bachmann.

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Bachmann, C., Schmidt, S., Staebler, A. et al. CNS metastases in breast cancer patients: prognostic implications of tumor subtype. Med Oncol 32, 400 (2015). https://doi.org/10.1007/s12032-014-0400-2

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  • DOI: https://doi.org/10.1007/s12032-014-0400-2

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