The presentation of brain metastases in melanoma, non-small cell lung cancer, and breast cancer and potential implications for screening brain MRIs.

Abstract

PURPOSE:

This study assessed the presentation and institutional outcomes treating brain metastases (BM) of breast cancer (BC), non-small cell lung cancer (NSCLC), and melanoma origin.

METHODS:

Patients with brain metastases treated between 2014 and 2019 with primary melanoma, NSCLC, and BC were identified. Overall survival (OS) was calculated from dates of initial BM diagnosis using the Kaplan-Meier method.

RESULTS:

A total of 959 patients were identified including melanoma (31%), NSCLC (51%), and BC (18%). Patients with BC were younger at BM diagnosis (median age: 57) than NSCLC (65) and melanoma patients (62, p < 0.0001). Breast cancer patients were more likely to present with at least 5 BM (27%) than NSCLC (14%) and melanoma (13%), leptomeningeal disease (23%, 6%, and 6%, p = 0.0004) and receive whole brain radiation therapy (WBRT) (58%, 37%, and 22%, p < 0.0001). There were no differences in surgical resection (24%, 24%, and 29%, p = 0.166). Median OS was shorter for BC patients (9.9, 10.3, and 13.7 months, p = 0.0006).

CONCLUSION:

Breast cancer patients were more likely to be younger, present with advanced disease, require WBRT, and have poorer OS than NSCLC and melanoma patients. Further investigation is needed to determine which BC patients are at sufficient risk for brain MRI screening.

• Authors: Matthew N Mills, Thrisha K Potluri, Yuki Kawahara, Matthew Fahey, Nicholas B Figura, Aixa E Soyano, Iman R Washington, Roberto Diaz, Daniel E Oliver, Hsiang-Hsuan Michael Yu, Arnold B Etame, Michael A Vogelbaum, Brian J Czerniecki, John A Arrington, Solmaz Sahebjam, Peter A Forsyth, Hatem H Soliman, Hyo S Han, Kamran A Ahmed
• Journal: Breast cancer research and treatment (Breast Cancer Res Treat) Vol. 191 Issue 1 Pg. 209-217 (Jan 2022) ISSN: 1573-7217 [Electronic] Netherlands
• PMID: 34669082 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Topics

• Brain
• Brain Neoplasms (diagnostic imaging, epidemiology)
• Breast Neoplasms (diagnostic imaging, epidemiology)
• Carcinoma, Non-Small-Cell Lung (diagnostic imaging, epidemiology)
• Early Detection of Cancer
• Female
• Humans
• Lung Neoplasms (diagnostic imaging)
• Magnetic Resonance Imaging
• Melanoma (diagnostic imaging)
• Middle Aged
• Retrospective Studies