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Purpose <p>Breast cancer (BC) is one of the most common primary tumor entities that develop brain metastases (BM) during disease progression. Multiple BM are associated with poorer prognosis, but various surgical, radiotherapeutic and systemic treatment approaches improve survival. We aimed to identify prognostic factors and evaluate the overall survival following BM surgery in patients with multiple BCBM.</p> Methods <p>All metachronous metastasized female patients with resected BCBM at our institution between 2008 and 2019 were included. Data on clinical, radiologic, and histopathologic parameters were recorded and analyzed using univariate and multivariate regression models.</p> Results <p>Among the 93 patients included in the final analysis, 30 individuals presented with multiple BM. Compared to patients with single BM, those with multiple BM were more likely to have infratentorial BM (adjusted odds ratio [aOR] 3.35, 95% confidence interval [CI] 1.03–10.83, <i>p</i> = 0.044), HER2(human epidermal growth factor receptor 2)-positive BC (aOR 3.93, 95% CI 1.23–12.53, <i>p</i> = 0.021) and hepatic metastases (aOR 5.86, 95% CI 1.34–25.61, <i>p</i> = 0.019). There was no significant difference in postoperative survival between individuals with multiple (median: 12.5 months) and single BM (17.0 months, <i>p</i> = 0.186). In the multivariate Cox regression analysis, adjuvant radiotherapy (adjusted hazard ratio [aHR] 5.93, 95% CI 1.06–33.26, <i>p</i> = 0.043) and trastuzumab treatment (aHR 4.95, 95% CI 1.72–14.25, <i>p</i> = 0.003) were associated with longer postoperative survival multiple BCBM patients.</p> Conclusion <p>BC patients with multiple BM show remarkable postoperative survival, particularly if combined with adjuvant radiotherapy. Our data justify the surgery of multiple BCBM in patients with appropriate clinical condition and feasible location of BM.</p>

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Surgical treatment of multiple breast cancer brain metastases: clinical characteristics and factors impacting postoperative survival

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月29日

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  • Anna Michel,
  • Laurèl Rauschenbach,
  • Hanah Karadachi,
  • Meltem Gümüs,
  • Yahya Ahmadipour,
  • Marvin Darkwah Oppong,
  • Christoph Pöttgen,
  • Jörg Hense,
  • Neriman Özkan,
  • Karsten H. Wrede,
  • Philipp Dammann,
  • Ulrich Sure,
  • Ramazan Jabbarli

摘要

Purpose

Breast cancer (BC) is one of the most common primary tumor entities that develop brain metastases (BM) during disease progression. Multiple BM are associated with poorer prognosis, but various surgical, radiotherapeutic and systemic treatment approaches improve survival. We aimed to identify prognostic factors and evaluate the overall survival following BM surgery in patients with multiple BCBM.

Methods

All metachronous metastasized female patients with resected BCBM at our institution between 2008 and 2019 were included. Data on clinical, radiologic, and histopathologic parameters were recorded and analyzed using univariate and multivariate regression models.

Results

Among the 93 patients included in the final analysis, 30 individuals presented with multiple BM. Compared to patients with single BM, those with multiple BM were more likely to have infratentorial BM (adjusted odds ratio [aOR] 3.35, 95% confidence interval [CI] 1.03–10.83, p = 0.044), HER2(human epidermal growth factor receptor 2)-positive BC (aOR 3.93, 95% CI 1.23–12.53, p = 0.021) and hepatic metastases (aOR 5.86, 95% CI 1.34–25.61, p = 0.019). There was no significant difference in postoperative survival between individuals with multiple (median: 12.5 months) and single BM (17.0 months, p = 0.186). In the multivariate Cox regression analysis, adjuvant radiotherapy (adjusted hazard ratio [aHR] 5.93, 95% CI 1.06–33.26, p = 0.043) and trastuzumab treatment (aHR 4.95, 95% CI 1.72–14.25, p = 0.003) were associated with longer postoperative survival multiple BCBM patients.

Conclusion

BC patients with multiple BM show remarkable postoperative survival, particularly if combined with adjuvant radiotherapy. Our data justify the surgery of multiple BCBM in patients with appropriate clinical condition and feasible location of BM.