Inflammatory breast cancer and development of brain metastases: risk factors and outcomes

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• 作者：Laura E. G. Warren ; Hao Guo ; Meredith M. Regan…
• 关键词：Inflammatory breast cancer ; Brain metastases ; Surveillance
• 刊名：Breast Cancer Research and Treatment
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：151
• 期：1
• 页码：225-232
• 全文大小：515 KB
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• 作者单位：Laura E. G. Warren (1)
  Hao Guo (2)
  Meredith M. Regan (2)
  Faina Nakhlis (3)
  Eren D. Yeh (4)
  Heather A. Jacene (5)
  Judi Hirshfield-Bartek (6)
  Beth A. Overmoyer (6)
  Jennifer R. Bellon (7)
  
  1. Harvard Radiation Oncology Program, Boston, MA, USA
  2. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
  3. Department of Surgery, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA
  4. Division of Breast Imaging, Department of Radiology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA
  5. Division of Nuclear Medicine, Department of Radiology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA
  6. Department of Medical Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA
  7. Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  
• 出版者：Springer Netherlands
• ISSN：1573-7217

文摘

Brain metastases are associated with significant morbidity. Minimal research has been conducted on the risk factors for and incidence of brain metastases in women with inflammatory breast cancer (IBC). 210 women with Stage III or IV IBC diagnosed from 1997-011 were identified. Competing risk analysis and competing risks regression were used to calculate the incidence of brain metastases and identify significant risk factors. After a median follow-up in surviving patients of 2.8?years (range 0.6-.6) and 3.3?years (range 0.2-4.5) in the 47 and 163 patients with (MET) and without (non-MET) metastatic disease at diagnosis, 17 (36?%) and 30 (18?%) developed brain metastases, respectively. The cumulative incidence at 1, 2, and 3?years was 17?% [95?% confidence interval (CI), 8-0], 34?% (95?% CI, 20-8), and 37?% (95?% CI, 22-1) for the MET cohort. The corresponding non-MET values were 4?% (95?% CI, 2-), 8?% (95?% CI 5-3), and 15?% (95?% CI, 10-2). Once non-MET patients developed extracranial distant metastases, the subsequent 1, 2, and 3?years cumulative incidence of brain metastases was 18?% (95?% CI, 10-8), 25?% (95?% CI, 15-6), and 31?% (95?% CI, 20-3). On multivariate analysis, brain metastases were associated with younger age [hazard ratio (HR), 0.73; 95?% CI, 0.53-.00; P?=?0.05] and distant metastases at diagnosis (HR, 2.33; 95?% CI, 1.11-.89; P?=?0.03). The incidence of brain metastases is high in women with IBC. Particularly for patients with extracranial distant metastases, routine screening with magnetic resonance imaging should be considered.