Brain Metastases in Triple Receptor - Negative Breast Cancer : Frequency , Risk Groups and Prognosis

Objectives: The aim of this retrospective analysis is to determine the frequency, pattern, risk factors and survival of triple receptor-negative breast cancer (TNBC) focusing on brain metastases. Methods: From January 2001 to December 2007, a total of 123 patients with stage I through III TNBC were treated at the Department of Clinical Oncology, Tanta University Hospital. Patients were reviewed to define the frequency, risk groups , survival and prognosis of brain metastases in TNBC. Follow-up lasted until September 30, 2012.Results: The ages ranged from 30 to 70 years (mean, 48.87 years). Fifteen patients (12.20%) out of 123 patients developed brain metastasis and in 10 (8.13%) of them the brain was the first site of metastasis. Eleven (73.3%) out of this 15 patients developed brain metastases within 1 year of their primary diagnosis, and 8 patients out of these 11 patients developed brain metastases within the first 3 months. The incidence of brain metastases was significantly higher in premenopausal patients (p = 0.009), and patients who did not received postoperative radiotherapy (p <.001).There was a significant direct correlation between the developments of brain metastases overall or as the first site of recurrence and lymphovascular invasion, tumor size, nodal status, and tumor grade (all p <.001). Pathological type, regimen of chemotherapy and type of surgery were not statistically significant factors. Non-brain metastases occurred in 25 patients (20.33%). Disease-free survival for all patients with TNBC (n =123) at 2 and 5 years were 70% and 63%, respectively, while overall survival at 2 and 5 years were 85% and 70%, respectively. Median survival for the 15 patients who developed brain metastases was 3.03 months (95% CI 1.77 to 4.29 months) and for those 10 patients who developed brain metastases as the first site of recurrence was 3 months (95% CI 2.18 to 3.82 months). Median survival among those with distant metastases who did not develop brain metastases at all (25 patients) was 15.17 months (95% CI 0.97-29.36 months) (P = 0.01). Conclusions: TNBC patients have high risk of earlier brain metastasis with the highest incidence during the first year after diagnosis with poor prognosis. [Hesham Tawfik. Brain Metastases in Triple Receptor-Negative Breast Cancer: Frequency, Risk Groups and Prognosis. Life Sci. J 2014;11(10):774-780] (ISSN: 1097-8135). http://www.lifesciencesite.com. 125