Pattern of Metastasis as a Risk Factor for Brain Metastasis in Patients With Breast Cancer: A Time-Dependent Cox...

Area of Science:

• Oncology
• Medical Statistics

Background:

• Brain metastasis significantly worsens prognosis in breast cancer patients.
• Existing predictive models lack clinical utility due to reliance on static baseline characteristics.

Purpose of the Study:

• To identify factors associated with brain metastasis development in breast cancer.
• To utilize time-dependent Cox regression for dynamic risk assessment.

Main Methods:

• Retrospective review of 2459 breast cancer patients undergoing surgery (2002-2020).
• Time-dependent covariate analysis incorporating the number of metastatic organs.
• Multivariable Cox regression to determine independent predictors of brain metastasis.

Main Results:

• Brain metastasis occurred in 2.4% of patients over a median 62-month follow-up.
• Advanced T stage, hormone receptor negativity, and metastatic organ burden independently predicted brain metastasis.
• Increased metastatic burden showed significantly higher hazard ratios (HRs) for brain metastasis.
• Bone metastasis was associated with a lower risk (HR=0.280), while soft tissue metastasis increased risk (HR=4.048).

Conclusions:

• The number and site of distant metastases are critical risk factors for brain metastasis.
• Personalized brain screening strategies are recommended for high-risk breast cancer patients to enable early detection.