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Metástases cerebrais do cancro de mama : estudo da população das doentes do serviço de oncologia médica do HSM - CHLN

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Resumo:The growing incidence of brain metastases from breast cancer may be due to the diagnostic accuracy improvement, but also to the therapeutic progress which, giving a survival advantage, enables brain metastases to develop. Various risk factors have been related to this metastasis pattern, among which are: early age of diagnosis, triple-negative phenotype (TN), negative hormone receptor status, positive HER2 status and treatment with trastuzumab.The main point of our study is to analyze breast cancer patients with brain metastases, who were treated in Medical Oncology Department of Hospital de Santa Maria, trying to identify characteristics possibly related to this metastasis pattern. The median age of diagnosis was 52 years-old and most of the patients were classified as stage I or II, at the time of the diagnosis. The histopathological classification showed 41% TN, 23% Luminal A, 14% Luminal B and 18% HER2. The majority of them are negative for both hormone receptors and HER2 status. The median time to brain metastasis was 33 months and median overall survival (OS) was 85 months, without significant differences between histopathological subgroups. The survival after metastasis, with a 16 months median, was significantly lower in TN and HER2 negative patients, but higher in patients who had solitary metastases (versus multiple), as well as the ones who underwent neurosurgery. As our sample contains a small number of patients, these data should be interpreted just as trends. In our sample, the primary tumor phenotype seems to be a differentiator factor only in what the survival after brain metastases is concerned. Although, the current knowledge suggests that extracranial disease control is the main survival determining factor. Besides that, topics as prophylactic strategies in patients with higher risk to brain metastasis and intracranial disease control, are currently under discussion.
Autores principais:Simões, Joana
Assunto:Oncologia Cancro da mama Metástases cerebrais
Ano:2014
País:Portugal
Tipo de documento:dissertação de mestrado
Tipo de acesso:acesso restrito
Instituição associada:Universidade de Lisboa
Idioma:português
Origem:Repositório da Universidade de Lisboa
Descrição
Resumo:The growing incidence of brain metastases from breast cancer may be due to the diagnostic accuracy improvement, but also to the therapeutic progress which, giving a survival advantage, enables brain metastases to develop. Various risk factors have been related to this metastasis pattern, among which are: early age of diagnosis, triple-negative phenotype (TN), negative hormone receptor status, positive HER2 status and treatment with trastuzumab.The main point of our study is to analyze breast cancer patients with brain metastases, who were treated in Medical Oncology Department of Hospital de Santa Maria, trying to identify characteristics possibly related to this metastasis pattern. The median age of diagnosis was 52 years-old and most of the patients were classified as stage I or II, at the time of the diagnosis. The histopathological classification showed 41% TN, 23% Luminal A, 14% Luminal B and 18% HER2. The majority of them are negative for both hormone receptors and HER2 status. The median time to brain metastasis was 33 months and median overall survival (OS) was 85 months, without significant differences between histopathological subgroups. The survival after metastasis, with a 16 months median, was significantly lower in TN and HER2 negative patients, but higher in patients who had solitary metastases (versus multiple), as well as the ones who underwent neurosurgery. As our sample contains a small number of patients, these data should be interpreted just as trends. In our sample, the primary tumor phenotype seems to be a differentiator factor only in what the survival after brain metastases is concerned. Although, the current knowledge suggests that extracranial disease control is the main survival determining factor. Besides that, topics as prophylactic strategies in patients with higher risk to brain metastasis and intracranial disease control, are currently under discussion.