Prognostic Factors for Intracranial Progression in Her-2-Overexpressing Breast Cancer Patients with Brain Metastases...

Background: Her-2 positive breast cancer is characterised by a high risk of metastases to the central nervous system, which significantly affects prognosis. The aim of this study was to analyse risk factors and treatment outcomes for brain metastases diagnosed at the time of first progression. Materials and Methods: A retrospective analysis was conducted on 1226 patients treated between 2010 and 2022. Distant metastases were diagnosed in 186 (15.7%) patients, including 48 (25.8%) with BM at the time of first progression. The impact of clinical factors and treatment on overall survival (OS) and intracranial progression-free survival (PFS) was analysed. Results: Patients with BM were significantly younger than other patients with distant metastases (mean 52.4 years vs. 61.1 years, p = 0.0001). The most significant prognostic factor for OS was the number of intracranial lesions (p = 0.0004). OS did not differ significantly depending on the use of local therapy (local therapy vs. whole-brain radiotherapy) or systemic therapy (observation vs. chemotherapy vs. anti-Her2 treatment). Conclusions: The number of brain metastases remains a key prognostic factor and should be taken into account in therapeutic decision-making, which highlights the importance of early identification of high-risk patients and the number of intracranial lesions in treatment selection.