Surgical treatment of multiple breast cancer brain metastases: clinical characteristics and factors impacting postoperative survival - Report - MDSpire
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Surgical treatment of multiple breast cancer brain metastases: clinical characteristics and factors impacting postoperative survival
Surgical Management of Brain Metastases from Breast Cancer: Survival Influences
Overview
This study analyzed outcomes of 93 breast cancer patients undergoing surgical resection of brain metastases (BM), comparing single versus multiple BM cases. Key factors influencing postoperative survival included receptor status, tumor localization, and presence of hepatic metastases.
Background
Breast cancer is a leading malignancy in women with brain metastases occurring in 15-50% of cases depending on subtype. Brain involvement significantly worsens morbidity and mortality. Surgical resection is an established treatment for single BM, but its role in multiple BM remains controversial. Understanding clinical features and survival factors post-surgery can guide treatment decisions.
Data Highlights
Characteristic
Single BM (n=63)
Multiple BM (n=30)
p-value
Median Age at BC Diagnosis (years)
52.0 (IQR 45.5–62.5)
Not specified
Not specified
Number of BM
1
2-9 (most common 2)
-
Negative PR Status in BM
Less frequent
More frequent
0.016
Infratentorial Tumor Localization
Less frequent
More frequent
0.002
Hepatic Metastasis
Less frequent
More frequent
0.020
Positive HER2 Status in BC
Less frequent
More frequent
0.012
Key Findings
Infratentorial tumor localization was significantly associated with multiple brain metastases.
Presence of hepatic metastases correlated independently with multiple brain metastases in multivariate analysis.
Positive HER2 receptor status in primary breast cancer was more common in patients with multiple brain metastases.
Surgical resection of brain metastases, including multiple lesions, may provide survival benefits and allows histological evaluation to tailor systemic therapy.
Postoperative survival varied depending on number of metastases, systemic disease extent, and molecular subtype.
Clinical Implications
Surgical resection remains a valuable option for selected breast cancer patients with brain metastases, including those with multiple lesions. Identifying receptor status and metastatic patterns such as hepatic involvement can inform prognosis and guide individualized treatment planning. Multidisciplinary approaches are essential for optimizing outcomes in this complex patient population.
Conclusion
Surgical management of brain metastases from breast cancer demonstrates distinct clinical features between single and multiple lesions, with several factors influencing postoperative survival. Tailored surgical and systemic therapies based on these findings may improve patient outcomes.
References
Various Authors/Institutional Study/2024 -- Surgical Management of Brain Metastases from Breast Cancer
by 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
