Identifying breast cancer patients at risk for Central Nervous System (CNS) metastases in trials of the International Breast Cancer Study Group (IBCSG)

Pestalozzi, BC; Zahrieh, D; Price, KN; Holmberg, SB; Lindtner, J; Collins, J; Crivellari, D; Fey, MF; Murray, E; Pagani, O; Simoncini, E; Castiglione-Gertsch, M; Gelber, RD; Coates, AS; Goldhirsch, A; International, Breast Cancer Study Group (IBCSG) (2006). Identifying breast cancer patients at risk for Central Nervous System (CNS) metastases in trials of the International Breast Cancer Study Group (IBCSG). Annals of oncology, 17(6), pp. 935-44. Oxford: Oxford University Press 10.1093/annonc/mdl064

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BACKGROUND: We sought to determine whether a high-risk group could be defined among patients with operable breast cancer in whom a search of occult central nervous system (CNS) metastases was justified. PATIENTS AND METHODS: We evaluated data from 9524 women with early breast cancer (42% node-negative) who were randomized in International Breast Cancer Study Group clinical trials between 1978 and 1999, and treated without anthracyclines, taxanes, or trastuzumab. We identified patients whose site of first event was CNS and those who had a CNS event at any time. RESULTS: Median follow-up was 13 years. The 10-year incidence (10-yr) of CNS relapse was 5.2% (1.3% as first recurrence). Factors predictive of CNS as first recurrence included: node-positive disease (10-yr = 2.2% for > 3 N+), estrogen receptor-negative (2.3%), tumor size > 2 cm (1.7%), tumor grade 3 (2.0%), < 35 years old (2.2%), HER2-positive (2.7%), and estrogen receptor-negative and node-positive (2.6%). The risk of subsequent CNS recurrence was elevated in patients experiencing lung metastases (10-yr = 16.4%). CONCLUSION: Based on this large cohort we were able to define risk factors for CNS metastases, but could not define a group at sufficient risk to justify routine screening for occult CNS metastases.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Fey, Martin and Castiglione-Gertsch, Monica

ISSN:

0923-7534

ISBN:

16603601

Publisher:

Oxford University Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:46

Last Modified:

22 Oct 2019 21:08

Publisher DOI:

10.1093/annonc/mdl064

PubMed ID:

16603601

Web of Science ID:

000237696000009

BORIS DOI:

10.7892/boris.18989

URI:

https://boris.unibe.ch/id/eprint/18989 (FactScience: 1279)

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