Aim: To perform a comprehensive analysis of patients with breast cancer and solitary or single brain metastasis and to analyze factors influencing survival from brain metastasis. Methods: One hundred consecutive patients with single or solitary brain metastasis were treated in one institution in the years 2003-2009. Brain lesions were diagnosed by magnetic resonance imaging (MRI). A total of 57% of patients underwent resection of brain metastasis, 95% of patients received whole-brain radiation therapy (WBRT) and 67% were treated systemically after WBRT. Results: Median survival from the detection of brain metastasis was 13 months and 28% of patients survived for 2 years. In 29 patients with solitary brain metastasis, median survival was 20 months (2-80 months) and in 71 patients with single brain metastasis it was 11 months (1-79 months) p = 0.01. Median survival from brain metastasis in patients with Recursive Partitioning Analysis Radiation Therapy Oncology Group (RPA RTOG) prognostic class I, II and III was 22 months (4-80 months), 13 months (2-79 months) and 6 months (0.4-28 months), respectively, p < 0.0001. Median survival from brain metastasis in triple-negative, HER2, luminal B and luminal A subtypes was 11 months, 13 months, 16 months and 15 months, respectively (p = 0.60). Multivariate analysis revealed that RPA RTOG prognostic class I, neurosurgery and systemic therapy after WBRT were factors that correlated with survival. Conclusions: In patients with one metastatic lesion in the brain, affiliation to RPA RTOG prognostic class I and intensive local and systemic treatment had a strong correlation with survival. There was no significant correlation between biological subtype of cancer and survival.

Breast cancer, RPA RTOG prognostic class, Single brain metastasis, Solitary brain metastasis, Systemic therapy,
European Journal of Surgical Oncology
Erasmus MC: University Medical Center Rotterdam

Niwińska, A, Pogoda, K, Murawska, M, & Niwiński, P. (2011). Factors influencing survival in patients with breast cancer and single or solitary brain metastasis. European Journal of Surgical Oncology, 37(7), 635–642. doi:10.1016/j.ejso.2011.05.002