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Abstract
Purpose: We aimed to investigate manifestations and patterns of care for patients with brain metastasis (BM) from breast cancer (BC) and compared their overall survival (OS) from 2005 through 2014 in Korea.

Materials and methods: We retrospectively reviewed 600 BC patients with BM diagnosed between 2005 and 2014. The median follow-up duration was 12.5 months. We categorized the patients into three groups according to the year when BM was initially diagnosed (group I [2005-2008], 98 patients; group II [2009-2011], 200 patients; and group III [2012-2014], 302 patients).

Results: Over time, the median age at BM diagnosis increased by 2.2 years (group I, 49.0 years; group II, 48.3 years; and group III, 51.2 years; p=0.008). The percentage of patients with extracranial metastasis was 73.5%, 83.5%, and 86.4% for group I, II, and III, respectively (p=0.011). The time interval between BC and BM was prolonged in patients with stage III primary BC (median, 2.4 to 3 years; p=0.029). As an initial brain-directed treatment, whole-brain radiotherapy alone decreased from 80.0% in 2005 to 41.1% in 2014. Meanwhile, stereotactic radiosurgery or fractionated stereotactic radiotherapy alone increased from 13.3% to 34.7% during the same period (p=0.005). The median OS for group I, II, and III was 15.6, 17.9, and 15.0 months, respectively, with no statistical significance.

Conclusion: The manifestations of BM from BC and the pattern of care have changed from 2005 to 2014 in Korea. However, the OS has remained relatively unchanged over the 10 years.

그림1. Trend of radiotherapy for brain metastasis (BM) from breast cancer: all patients (A), patients with 1-4 BM (B), and patients with more than 4 BM (C).

그림2.Kaplan-Meier curve of overall survival according to the year of brain metastasis (BM).

Affiliations

Jae Sik Kim 1, Kyubo Kim 2, Wonguen Jung 2, Kyung Hwan Shin 1, Seock-Ah Im 3, Hee-Jun Kim 4, Yong Bae Kim 5, Jee Suk Chang 5, Jee Hyun Kim 3, Doo Ho Choi 6, Yeon Hee Park 7, Dae Yong Kim 8, Tae Hyun Kim 8, Byung Ock Choi 9, Sea-Won Lee 9 10, Suzy Kim 11, Jeanny Kwon 12, Ki Mun Kang 13, Woong-Ki Chung 14, Kyung Su Kim 2 15, Ji Ho Nam 16, Won Sup Yoon 17, Jin Hee Kim 18, Jihye Cha 19, Yoon Kyeong Oh 20, In Ah Kim 1 21
1Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
2Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea.
3Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
4Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
5Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
6Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
7Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
8Proton Therapy Center, National Cancer Center, Goyang, Korea.
9Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
10Department of Radiation Oncology, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
11Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
12Department of Radiation Oncology, Chungnam National University College of Medicine, Daejeon, Korea.
13Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea.
14Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
15Department of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea.
16Department of Radiation Oncology, Yangsan Pusan National University Hospital, Pusan National University School of Medicine, Yangsan, Korea.
17Department of Radiation Oncology, Korea University Ansan Hospital, Korea University College of Medicine, Asan, Korea.
18Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
19Department of Radiation Oncology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
20Department of Radiation Oncology, Chosun University Medical School, Gwangju, Korea.
21Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.