Geburtshilfe Frauenheilkd 2008; 68 - PO_Onko_02_09
DOI: 10.1055/s-0028-1088977

Cerebral metastases (CM) in breast cancer (BC) with focus on “triple- negative“ (TN) tumors

F Heitz 1, P Harter 1, B Beutel 1, HJ Lueck 1, A Traut 1, A du Bois 2
  • 1HSK, Dr. Horst Schmidt Klinik GmbH, Klinik für Gynäkologie & Gynäkologische Onkologie, Wiesbaden
  • 2Klinik für Gynäkologie & Gyn. Onkologie, HSK, Dr. Horst Schmidt Klinik, Wiesbaden

Purpose: We analysed the impact of TN-BC -characterized by ER-/PR-/Her2neu- in respect of CM

Methods: Retrospective analysis of in 3,193 BC pts. treated consecutively between '89 and '06 in our EUSOMA breast unit. All pts. developing CM were included.

Results: 338 pts. suffered from TN-BC (10.58%) and 80 pts. (2.5%) developed CM within a median observation period of 51 months. 19 pts. (23.75%) with CM had TN-BC and 5,6% with TN-BC had CM. Multivariate analysis indicated the highest risk for developing CM for TN-BC compared with all other types of BC (OR: 4.16; 95% CI: 2.26–7.64;p<0.001). Further independent risk factors were: ER-/PR-/Her2neu+ (OR: 3.43; 95% CI: 1.46–8.05;p=0.005), age ≤ 50 years (OR: 2.02; 95% CI: 1.17–3.49;p=0.012), UICC-stages III/IV (OR: 2.49; 95% CI: 1.19–5.22;p=0,016) and positive nodal-status (OR: 2.37; 95% CI: 1.10–5.10;p=0.028). In addition, TN-BC showed inferior PFS and OS with 23 and 31.5 mos compared to 49.5 and 72 mos in other BC types (PFS: OR: 3.2; 95% CI: 2.1–18.1;p<0.0001/OS: OR 3.3; 95% CI: 2.7–18.8;p<0.0001), respectively. The median interval between primary diagnosis and occurrence of CM was 22 mos in TN-BC and 51 mos in other BC (OR: 2.7; 95% CI: 2.4–11.4;p<0.0001). OS after occurrence of CM was 4 mos in TN-BC and 8 mos on other BC, this trend was not significant.

Conclusions: Patients with TN-BC have a higher risk for developing CM. Even in pts. with CM, TN-BC represent a poor prognostic subgroup and CM occurred earlier and showed a trend for poorer outcome. Specific treatment regimens for this poor prognostic subgroup are warranted and the relative high incidence of CM in TN-BC questions if extended diagnostics (eg. routine CNS MRI) should be applied to these pts.