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Salud Pública de México
versión impresa ISSN 0036-3634
Resumen
MOHAR-BETANCOURT, Alejandro et al. Prognostic factors in patients with breast cáncer and brain metastasis as the first site of recurrence. Salud pública Méx [online]. 2018, vol.60, n.2, pp.141-150. ISSN 0036-3634. https://doi.org/10.21149/9082.
Objective:
To evaluate the prognostic factors (clinical-pathological characteristics and treatments) in patients with breast cancer and metastasis to central nervous system (CNS) as the first site of the disease.
Materials and methods:
Kaplan-Meier method and life tables were used to estimate overall survival time over a retrospective cohort of 125 breast cancer patients treated at the Instituto Nacional de Cancerología (INCan) during 2007-2015, who presented metastasis to the CNS as the first site of extension of the disease. The cox proportional hazards model was used to determine the prognosis factors.
Result:
The median overall survival time was 14.2 months (IC95%: 11.83-26.93). Patients with triple negative (TN), according to inmunohistochemistry analysis classification, had lower survival times (p=0.0004) and had a risk of dying two times (p=0.037) higher than patients with a different immunophenotype (HR: 2.77. 95%CI: 1.10-6.99). The degree of intermediate SBR increases the risk of dying in patients with metastasis (HR 2.76, 95% CI: 1.17-6.51).
Conclusion:
CNS metastasis continues to be a poor prognostic factor that reduces survival and affects quality of life. It is recommended to monitor the early presence of clinical neurological manifestations during follow-up for prompt treatment. TN patients have worse prognosis and HER2+ a better control.
Palabras llave : neoplasm metastasis; breast neoplasms; central nervous system; prognosis.