Summary: Individuals with a rare type of breast cancer called inflammatory breast cancer are at greater risk of their cancer spreading to the brain.
New research indicates that among individuals with breast cancer, those with a rare subtype called inflammatory breast cancer face a higher risk that their cancer will spread, or metastasize, to the brain.
The study is published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.
Studies have demonstrated higher rates of brain metastases in patients with inflammatory breast cancer, but detailed information is lacking. To provide insights into the incidence and risk factors for brain metastases in this patient population, Laura E.G. Warren, MD, of the Dana-Farber Cancer Institute, and her colleagues analyzed data on 372 patients with stage III inflammatory breast cancer and 159 with stage IV inflammatory breast cancer.
Over a median follow-up of 5 years, the incidence of brain metastases at 1, 2, and 5 years was 5%, 9%, and 18% among patients who presented with stage III disease, and 17%, 30%, and 42% among those with stage IV disease.
Patients with triple-negative breast cancer faced a particularly high risk, and when they did experience brain metastases, their survival time was shorter than those with hormone receptor–positive or HER2-positive breast cancer who experienced brain metastases.
Higher risks of brain metastases were also seen in patients whose cancer had metastasized to other parts of the body besides the brain, especially when this occurred at a young age.
“The relatively high incidence of brain metastases seen in the study population highlights the need for future research on the potential role for surveillance brain imaging for high-risk patients. There is an open, phase II, single arm study at Dana-Farber Cancer Institute examining this question,” said Dr. Warren.
“It also emphasizes the need to obtain brain imaging in patients with inflammatory breast cancer presenting with neurologic symptoms given the high incidence of brain metastases in this population.”
Most patients in this study who were diagnosed with brain metastases had neurologic symptoms, but because some patients may have undetected, asymptomatic brain metastases, the true incidence in patients with inflammatory breast cancer is likely even higher than what Dr. Warren and her colleagues observed.
An accompanying editorial notes that when considering whether to implement routine brain imaging tests in patients with inflammatory breast cancer, it will be important to determine whether earlier detection of brain metastases leads to improvements in both survival and quality of life.
About this brain cancer research news
Author: Sara Henning-Stout
Contact: Sara Henning-Stout – Wiley
Image: The image is in the public domain
Original Research: Open access.
“Incidence, characteristics, and management of central nervous system metastases in patients with inflammatory breast cancer” by Laura E.G. Warren et al. CANCER
Incidence, characteristics, and management of central nervous system metastases in patients with inflammatory breast cancer
Patients with inflammatory breast cancer (IBC) have a high risk of central nervous system metastasis (mCNS). The purpose of this study was to quantify the incidence of and identify risk factors for mCNS in patients with IBC.
The authors retrospectively reviewed patients diagnosed with IBC between 1997 and 2019. mCNS-free survival time was defined as the date from the diagnosis of IBC to the date of diagnosis of mCNS or the date of death, whichever occurred first. A competing risks hazard model was used to evaluate risk factors for mCNS.
A total of 531 patients were identified; 372 patients with stage III and 159 patients with de novo stage IV disease. During the study, there were a total of 124 patients who had mCNS. The 1-, 2-, and 5-year incidence of mCNS was 5%, 9%, and 18% in stage III patients (median follow-up: 5.6 years) and 17%, 30%, and 42% in stage IV patients (1.8 years). Multivariate analysis identified triple-negative tumor subtype as a significant risk factor for mCNS for stage III patients. For patients diagnosed with metastatic disease, visceral metastasis as first metastatic site, triple-negative subtype, and younger age at diagnosis of metastases were risk factors for mCNS.
Patients with IBC, particularly those with triple-negative IBC, visceral metastasis, and those at a younger age at diagnosis of metastatic disease, are at significant risk of developing mCNS. Further investigation into prevention of mCNS and whether early detection of mCNS is associated with improved IBC patient outcomes is warranted.