Predictive Factors and Survival Rate for Brain Metastasis from Breast Cancer / 한국유방암학회지

PURPOSE: The incidence of symptomatic brain metastases from breast cancerhas ranged from 10% to 16%. Brain metastases are traditionally viewed as a late complication of systemic disease, for which few effective treatment options exist. The aim of this study was to evaluate the factors that can predict brain metastases and to analyze the survival rate as compared with other systemic metastases. METHODS: Between February 1983 and October 2005, 119 patient who developed systemic metastasis during the follow up period after optimal surgical treatment at Korea University Hospital were included in this study. Twenty-nine of these 119 patients had complaints of symptoms and they were consequently diagnosed as having brain metastases. RESULTS: Estrogen receptor (-), progesterone receptor (-) and Her2 (-), and Triple negative were a significantly higher in the patients with brain metastases (p=0.04). The other clinicopathologic factors showed no difference between the patients with brain metastases and the patients without brain metastases. Lung metastases existed previously more often than the other systemic metastases (p=0.04). The overall survival of the patients with brain metastases was not significantly different from the patients with other systemic metastases. However, the disease specific survival of patients with brain metastases, as compared with other systemic metastases was poorer than that for patients with bone and lung metastases, respectively (p=0.01 and 0.03). A poor prognosis was shown for the cases with brain metastases within 1 yr after operation. CONCLUSION: Clinician should give attention to the possibility of brain metastases for the breast cancer patients with triple negative findings or the patients who have developed lung metastases as this represents a symptom of central nervous system.

S-phase Fraction as an Independent Prognostic Factor in Invasive Breast Carcinoma -A Study of Long-term Follow-up / 한국유방암학회지

PURPOSE: To evaluate the significance of the S-phase fraction (SPF) and DNA ploidy, determined by DNA flow cytometry, as prognostic markers in invasive breast cancer. METHODS: Between October 1986 and June 1999, 143 breast carcinoma patients, treated by surgery, were analyzed. Flow cytometry was performed for the identification of the SPF and DNA ploidy, with immunohistochemistry performed on paraffin embedded material for the hormone receptor. Two SPF classes were defined on the basis of the median value (10) by using a log rank test (high SPF>10, low SPF<10). The correlation between SPF and the clinicopathological factors (tumor size, lymph node status, histological grade and steroid receptor status) and between the SPF and 5 yr disease-free survival (DFS) were investigated. RESULTS: DNA ploidy was not associated with tumor size, lymph node status, histological grade, overall survival and DFS. In a univariate analysis, high SPF values were associated with shorter 5 yr DFS in individual groups. In the node negative group, the 5 yr DFS of the low SPF group was higher than that of the high SPF group, but in the node positive group, the SPF values showed statistical significance with the 5 yr DFS. In a multivariate analysis, the SPF was independently associated with the 5 yr DFS in the node negative group. CONCLUSION: These results suggested the SPF is an independent prognostic factor in lymph node negative, estrogen receptor positive and progesterone receptor negative breast cancers.