Cancer Res Treat.  2022 Oct;54(4):1121-1129. 10.4143/crt.2021.1083.

The Pattern of Care for Brain Metastasis from Breast Cancer over the Past 10 Years in Korea: A Multicenter Retrospective Study (KROG 16-12)

• Kim JS
• Kim K
• Jung W
• Shin KH
• Im SA
• Kim HJ
• Kim YB
• Chang JS
• Kim JH
• Choi DH
• Park YH
• Kim DY
• Kim TH
• Choi BO
• Lee SW
• Kim S
• Kwon J
• Kang KM
• Chung WK
• Kim KS
• Nam JH
• Yoon WS
• Kim JH
• Cha J
• Oh YK
• Kim IA

• KMID: 2534191
• DOI: http://doi.org/10.4143/crt.2021.1083

Abstract

Purpose
We aimed to investigate manifestations and patterns of care for patients with brain metastasis (BM) from breast cancer (BC) and compared their overall survival (OS) from 2005 through 2014 in Korea.
Materials and Methods
We retrospectively reviewed 600 BC patients with BM diagnosed between 2005 and 2014. The median follow-up duration was 12.5 months. We categorized the patients into three groups according to the year when BM was initially diagnosed (group I [2005-2008], 98 patients; group II [2009-2011], 200 patients; and group III [2012-2014], 302 patients).
Results
Over time, the median age at BM diagnosis increased by 2.2 years (group I, 49.0 years; group II, 48.3 years; and group III, 51.2 years; p=0.008). The percentage of patients with extracranial metastasis was 73.5%, 83.5%, and 86.4% for group I, II, and III, respectively (p=0.011). The time interval between BC and BM was prolonged in patients with stage III primary BC (median, 2.4 to 3 years; p=0.029). As an initial brain-directed treatment, whole-brain radiotherapy alone decreased from 80.0% in 2005 to 41.1% in 2014. Meanwhile, stereotactic radiosurgery or fractionated stereotactic radiotherapy alone increased from 13.3% to 34.7% during the same period (p=0.005). The median OS for group I, II, and III was 15.6, 17.9, and 15.0 months, respectively, with no statistical significance.
Conclusion
The manifestations of BM from BC and the pattern of care have changed from 2005 to 2014 in Korea. However, the OS has remained relatively unchanged over the 10 years.

Keyword

Brain metastasis; Breast neoplasms; Overall survival; Pattern of care study

Figure

• 

  Fig. 1 Time interval between primary breast cancer and brain metastasis according to tumor subtypes (A) and initial stage of primary breast cancer (B). Box plots present median value with 5–95 percentile. Adjusted p-values were calculated using Tukey’s multiple comparisons. BC, breast cancer; HER2, human epidermal growth factor receptor 2; HR, hormone receptor.

• 

  Fig. 2 Trend of radiotherapy for brain metastasis (BM) from breast cancer: all patients (A), patients with 1–4 BM (B), patients with more than 4 BM (C), according to tumor subtype (D), and according to breast cancer-specific graded prognostic assessment (E). FSRT, fractionated stereotactic radiotherapy; HER2, human epidermal growth factor receptor 2; HR, hormone receptor; SRS, stereotactic radiosurgery; WBRT, whole-brain radiotherapy. (Continued to the next page)

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  Fig. 3 Kaplan-Meier curve of overall survival according to the year of brain metastasis (BM).

Reference

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