Background/Objectives: Breast cancer is the most common malignancy in women and the second leading cause of cancer-related deaths globally. It is also the second most frequent source of brain metastases (BMs), contributing to 5–20% of cases. Despite this, routine brain imaging for screening is not recommended and is only conducted when clinical symptoms or physical findings suggest metastasis. This study aims to identify clinical predictors associated with overall survival (OS) and the timing of BM development in breast cancer patients. Methods: We performed a retrospective review of medical records for 113 patients diagnosed with BMs secondary to breast cancer at our institution between 2000 and 2020. Baseline demographic data and clinical characteristics related to BMs were collected. To identify factors associated with OS and time to BM development after breast cancer diagnosis, we conducted univariate analysis using Kaplan–Meier curves, bivariate analysis with the log-rank test, and multivariate analysis via the Cox Proportional Hazard model. Results: An early diagnosis of BMs was identified as a significant predictor of prolonged OS (aHR = 0.22; 95% CI: 0.049–0.98,p= 0.05). Post-menopausal status at breast cancer diagnosis (aHR = 1.69; 95% CI: 1.13–2.53,p= 0.01), Asian ethnicity (aHR = 2.30; 95% CI: 1.03–5.16,p= 0.04), and the ER+/HER2+ subtype (aHR = 2.06; 95% CI: 1.14–3.71,p= 0.02) were significantly associated with a shorter time to BM diagnosis. A subgroup analysis of patients with ER+ breast tumors revealed that Hispanic or Arabic ethnicity (aHR = 3.63; 95% CI: 1.34–9.81,p= 0.01) and stage IV diagnosis (aHR = 2.09; 95% CI: 1.16–3.76,p= 0.01) were significantly associated with shorter intervals to BM diagnosis. Conclusions: Breast cancer remains a significant global health burden for women, yet clear guidelines for routine BMs screening are still lacking. Early detection of BMs has been shown to notably improve long-term survival outcomes. Additionally, post-menopausal status, Hispanic or Arabic ethnicity, and the HER2+ tumor subtype are associated with shorter time to BM development, highlighting these factors as potential indicators for central nervous system screening.
背景/目的：乳腺癌是女性最常见的恶性肿瘤，也是全球癌症相关死亡的第二大原因。它同时也是脑转移的第二大常见来源，占脑转移病例的5%-20%。尽管如此，目前并不推荐将常规脑部影像学检查用于筛查，仅当出现临床症状或体格检查提示转移时才进行。本研究旨在确定与乳腺癌患者总生存期及脑转移发生时间相关的临床预测因素。方法：我们对2000年至2020年间在本机构诊断为乳腺癌继发脑转移的113例患者的病历进行了回顾性分析。收集了与脑转移相关的基础人口统计学数据和临床特征。为确定与总生存期及乳腺癌诊断后至脑转移发生时间相关的因素，我们采用Kaplan-Meier曲线进行单变量分析，对数秩检验进行双变量分析，并通过Cox比例风险模型进行多变量分析。结果：早期诊断脑转移被确定为延长总生存期的重要预测因素（调整后风险比=0.22；95%置信区间：0.049-0.98，p=0.05）。乳腺癌诊断时处于绝经后状态（调整后风险比=1.69；95%置信区间：1.13-2.53，p=0.01）、亚裔种族（调整后风险比=2.30；95%置信区间：1.03-5.16，p=0.04）以及ER+/HER2+亚型（调整后风险比=2.06；95%置信区间：1.14-3.71，p=0.02）与更短的脑转移诊断时间显著相关。对ER+乳腺肿瘤患者的亚组分析显示，西班牙裔或阿拉伯裔（调整后风险比=3.63；95%置信区间：1.34-9.81，p=0.01）和IV期诊断（调整后风险比=2.09；95%置信区间：1.16-3.76，p=0.01）与更短的脑转移诊断间隔显著相关。结论：乳腺癌仍然是全球女性面临的重大健康负担，但目前仍缺乏明确的常规脑转移筛查指南。早期发现脑转移已被证明能显著改善长期生存结局。此外，绝经后状态、西班牙裔或阿拉伯裔以及HER2+肿瘤亚型与更短的脑转移发生时间相关，这些因素可作为中枢神经系统筛查的潜在指标。
肿瘤(癌症)患者之家