Abstract：
BACKGROUND: Breast cancer (BC) is the second most common etiology of brain metastases (BrM). We aimed to examine the incidence of BrM among all BC patients presenting to a large tertiary cancer centre over one decade.
METHODS: We included all BC patients presenting consecutively between 2009 and 2019 and cross referenced that cohort to a radiotherapy database, identifying patients treated for BrM at any time following their initial presentation. Cumulative incidences (CI) of BrM diagnoses were calculated using death as a competing risk and compared using the Fine-Gray method. Overall survival was estimated using the Kaplan Meier method.
RESULTS: We identified 12,995 unique patients. The CI of BrM in patients who initially presented with Stage 0-4 disease was 2.1%, 3.7%, 9.4%, 10.6%, and 28.7%, respectively at 10 years. For 8,951 patients with available molecular subtype data, 6,470 (72%), 961 (11%), 1,023 (11%), and 497 (6%) had hormone-receptor (HR)-positive/ERBB2-, HR-negative/ERBB2-, HR-positive/ERBB2 + , and HR-negative/ERBB2 + disease, respectively; the CI of BrM in each was 7.6%, 25.3%, 24.1%, and 26.6%, at 10 years following BC diagnosis, respectively. Median overall survival (OS) following BC diagnosis and BrM diagnosis was 28 years 95% CI [25, 32] and 10 months 95% CI [9, 12], respectively.
CONCLUSIONS: From a large, registry-based study, we observed that patients with ERBB2 + and triple negative BC have the highest incidence of BrM. Our data supports prospective surveillance brain MRI studies. Given advancements in BrM treatment, clinicians should have a low threshold for brain imaging in BC patients with high risk subtypes.
METHODS: We included all BC patients presenting consecutively between 2009 and 2019 and cross referenced that cohort to a radiotherapy database, identifying patients treated for BrM at any time following their initial presentation. Cumulative incidences (CI) of BrM diagnoses were calculated using death as a competing risk and compared using the Fine-Gray method. Overall survival was estimated using the Kaplan Meier method.
RESULTS: We identified 12,995 unique patients. The CI of BrM in patients who initially presented with Stage 0-4 disease was 2.1%, 3.7%, 9.4%, 10.6%, and 28.7%, respectively at 10 years. For 8,951 patients with available molecular subtype data, 6,470 (72%), 961 (11%), 1,023 (11%), and 497 (6%) had hormone-receptor (HR)-positive/ERBB2-, HR-negative/ERBB2-, HR-positive/ERBB2 + , and HR-negative/ERBB2 + disease, respectively; the CI of BrM in each was 7.6%, 25.3%, 24.1%, and 26.6%, at 10 years following BC diagnosis, respectively. Median overall survival (OS) following BC diagnosis and BrM diagnosis was 28 years 95% CI [25, 32] and 10 months 95% CI [9, 12], respectively.
CONCLUSIONS: From a large, registry-based study, we observed that patients with ERBB2 + and triple negative BC have the highest incidence of BrM. Our data supports prospective surveillance brain MRI studies. Given advancements in BrM treatment, clinicians should have a low threshold for brain imaging in BC patients with high risk subtypes.
摘要：
背景：乳腺癌（BC）是脑转移（BrM）的第二常见病因。我们旨在研究十年来在大型三级癌症中心就诊的所有BC患者中BrM的发病率。
方法：我们纳入了2009年至2019年期间连续出现的所有BC患者，并将该队列与放疗数据库交叉引用，在初次就诊后的任何时间识别接受BrM治疗的患者。使用死亡作为竞争风险来计算BrM诊断的累积发生率（CI），并使用Fine-Gray方法进行比较。使用KaplanMeier方法估计总生存期。
结果：我们确定了12,995例独特患者。最初患有0-4期疾病的患者的BrM的TheCI为2.1％，3.7%,9.4%,10.6%,和28.7%，分别在10年。对于8,951名具有可用分子亚型数据的患者，6,470（72%），961（11%），1,023（11%），和497（6％）有激素受体（HR）阳性/ERBB2-，HR-阴性/ERBB2-,HR阳性/ERBB2+,和HR阴性/ERBB2+疾病，BrM的CI分别为7.6%，25.3%,24.1%,和26.6%，在BC诊断后10年，分别。BC诊断和BrM诊断后的中位总生存期（OS）为28年95％CI[25,32]和10个月95％CI[9,12]，分别。
结论：从一个大的，基于注册表的研究，我们观察到ERBB2+和三阴性BC患者的BrM发生率最高。我们的数据支持前瞻性监测脑MRI研究。鉴于BrM治疗的进展，对于高风险亚型的BC患者,临床医师的脑成像阈值应该较低.
方法：我们纳入了2009年至2019年期间连续出现的所有BC患者，并将该队列与放疗数据库交叉引用，在初次就诊后的任何时间识别接受BrM治疗的患者。使用死亡作为竞争风险来计算BrM诊断的累积发生率（CI），并使用Fine-Gray方法进行比较。使用KaplanMeier方法估计总生存期。
结果：我们确定了12,995例独特患者。最初患有0-4期疾病的患者的BrM的TheCI为2.1％，3.7%,9.4%,10.6%,和28.7%，分别在10年。对于8,951名具有可用分子亚型数据的患者，6,470（72%），961（11%），1,023（11%），和497（6％）有激素受体（HR）阳性/ERBB2-，HR-阴性/ERBB2-,HR阳性/ERBB2+,和HR阴性/ERBB2+疾病，BrM的CI分别为7.6%，25.3%,24.1%,和26.6%，在BC诊断后10年，分别。BC诊断和BrM诊断后的中位总生存期（OS）为28年95％CI[25,32]和10个月95％CI[9,12]，分别。
结论：从一个大的，基于注册表的研究，我们观察到ERBB2+和三阴性BC患者的BrM发生率最高。我们的数据支持前瞻性监测脑MRI研究。鉴于BrM治疗的进展，对于高风险亚型的BC患者,临床医师的脑成像阈值应该较低.
