Retrospective evaluation of the factor affecting survival in patients with breast cancer who developed brain metastasis followed up at The Medical Oncology Clinic of the Dicle University Medical Faculty

Purpose: Breast cancer is the most common cancer in women except non-melanoma skin cancer. Metastases in patients with breast cancer are the main cause of morbidity and mortality. Also, breast cancer is the second common cause of brain metastasis. Prognosis of breast cancer patients who developed brain metastasis is very poor and after developing the brain metastasis, survival is very short. In this study, factors affecting the survival were analyzed retrospectively for patients with breast cancer who developed brain metastasis and were followed up at the Medical Oncology Department, Medical Faculty of Dicle University. Method: In this study, factors affecting the survival were analyzed retrospectively for 130 patients with breast cancer brain metastasis from 1250 patients and were followed up between January 2011 and February 2019 at the Medical Oncology Department, Medical Faculty of Dicle University. Results: The average age of diagnosis, the average time between the diagnosis and the development of brain metastasis, and the general survival time after brain metastasis were found as 46 (21-74), 25 months (0-144) and 6 months (0-64) respectively. In terms of the time until the development of brain metastasis, in the univariate analysis, it was determined that being in phase I-II-III at the time of diagnosis, getting adjuvant chemotherapy and adjuvant hormone treatment are good prognostic factors (p<0.001, p<0.001 and p=0.004 respectively); also, in the multivariable analysis, it was detected that having metastatic cancer at the time of diagnosis and the performance score of 2 are related to the shorter time of developing brain metastasis; and getting adjuvant chemotherapy is related to the longer time of developing brain metastasis; and all of them were determined as the independent prognostic factors. In terms of the survival after brain metastasis, in the univariate analysis, treating with radiotherapy and surgical operation together as the local therapy, getting chemotherapy after metastasis, not developing neurological deficit, single brain metastasis, Trastuzumab administration, and Her-2 positiveness were detected as the good prognostic factors (p<0,001, p=0,009, p=0,013, p=0,015, p=0,025 and p=0,046, respectively); also, in the multivariate analysis, it was determined that leptomeningeal involvement and neurological deficit are correlated to shorter survival; getting chemotherapy, radiotherapy and surgical application after brain metastasis are related to longer survival and all of these are the independent prognostic factors. Conclusion: The data obtained from the patients with breast cancer who developed brain metastasis point out that follow up of breast cancer patients whose cancer is metastatic at the time of diagnosis and who have the performance score of 2, also, of metastatic breast cancer patients who developed leptomeningeal involvement and neurological deficit might enhance the survival.