Identifying risk factors for brain metastasis in breast cancer patients: Implication for a vigorous surveillance program
Identifying risk factors for brain metastasis in breast cancer patients: Implication for a vigorous surveillance program
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DOI：
10.1016/j.asjsur.2015.03.003
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发表时间：
2015-10-01
影响因子：
3.5
通讯作者：
Kwong, Ava
中科院分区：
文献类型：
--
作者：
Chow, Lorraine;Suen, Dacita;Kwong, Ava
目的：10-15%的转移性乳腺癌患者发生脑转移，且预后较差。本研究旨在探讨香港华人原发性乳腺癌与脑转移相关的肿瘤特征。方法：对2001年1月至2008年12月在某大学附属医院接受治疗的浸润性乳腺癌患者进行回顾性分析。分析脑转移患者的临床病理因素，并与未发生脑转移的患者进行比较。先用单因素分析确定脑转移的危险因素，再用多因素分析确定。结果：研究期间共有912例浸润性乳腺癌患者接受了治疗。其中，30名患者被发现有远处转移到脑部。脑转移患者的乳腺肿瘤组织学分级较高（III级，78.9% vs. 30.2%; p = 0.001）。她们的肿瘤雌激素受体阴性率也显著高于对照组（78.9% vs. 30.2%, p = 0.001）。在多变量分析中，只有高肿瘤分级被发现可以预测发生脑转移。结论：中国乳腺癌脑转移患者高级别肿瘤及雌激素受体阴性的发生率较高。对于这类患者，应该考虑对中枢神经系统进行更有力的监测。版权所有，亚洲外科协会。爱思唯尔台湾有限责任公司出版，版权所有。
Objective: Brain metastasis occurs in 10-15% of metastatic breast cancer patients and is associated with poor prognosis. This study aims to identify tumor characteristics of primary breast cancer, which are related to brain metastases in Hong Kong Chinese patients.Methods: A retrospective study of patients with invasive breast cancer receiving treatment in a university hospital from January 2001 to December 2008 was performed. The clinicopathological factors of patients with brain metastases were analyzed and compared with those who had no brain metastasis. Risk factors for brain metastasis were identified by univariate analysis first and then by multivariate analysis.Results: A total of 912 patients with invasive breast cancer were treated during the study period. Of these, 30 patients were found to have distant metastases to brain. Patients with brain metastases had more breast tumors of higher histological grade (Grade III, 78.9% vs. 30.2%; p = 0.001). Their tumors also had a significantly higher rate of negative estrogen receptors (78.9% vs. 30.2%, p = 0.001). On multivariate analysis, only high tumor grading was found to be predictive of developing brain metastasis.Conclusion: Chinese breast cancer patients with brain metastasis were more likely to have high-grade tumors and negative estrogen receptor status. A more vigorous surveillance program for the central nervous system should be considered for this group of patients. Copyright (C) 2015, Asian Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved.