The clinical course of 106 patients with brain metastases from breast cancer was retrospectively studied. Median time of survival after detection of intracranial metastases (SAR(ICM)) was 14 weeks (95% confidence limits: 10-19 weeks), and 25% of the patients survived for more than 37 weeks, while only 17% survived for one year. The occurrence of clinical, pathoanatomical and therapeutical variables in these patients were analyzed in a subgroup of 57 patients, who survived for less than 16 weeks, and compared with a subgroup of 49 patients, who survived for more than 16 weeks after detection of brain metastases. None of the variables studied were associated with either of the two prognostic groups. Patients with short SAR(ICM) had, however, a greater number of extra-cranial metastases at recurrence in the brain compared to patients with SAR(ICM) more than 16 weeks (p = 0.07).
Patients with SAR(ICM) less than 16 weeks had a somewhat shorter recurrence-flee interval (p = 0.22) and a significantly shorter time from primary diagnosis until detection of brain metastases (p = 0.04). Probably as a consequence of this, these patients had a shorter survival from primary diagnosis as well as from first recurrence. The findings may indicate that the differences in survival of patients with brain metastases are mainly due to differences in the rate of disease progression.
Abbreviations." ICM -intracranial metastases, RFI -recurrence-free interval, RFI(ICM) -time from initial diagnosis until diagnosis of ICM, SAR -survival after first recurrence, SAR(ICM) -survival after diagnosis of ICM