There are a few factors associated with an increased risk for central nervous system (CNS) metastases in patients with inflammatory breast cancer, according to new data published in Cancer.

The data suggest that patients who are younger at diagnosis, those with triple-negative disease, and those with visceral metastasis as the first metastatic site have an increased risk of CNS metastases.

For this analysis, researchers looked at 531 patients diagnosed with inflammatory breast cancer from 1997 to 2019 at a single institution.


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At diagnosis, 30% of patients had metastatic disease, and 3% had CNS metastases. During the study period, 23% of patients were diagnosed with CNS metastases. Throughout follow-up, 83% of patients with CNS metastases died. 

The median follow-up was 5.6 years for patients with stage III disease at diagnosis and 1.8 years for patients with stage IV disease at diagnosis.

Among the patients who presented with stage III disease, the incidence of CNS metastases was 5% at 1 year, 9% at 2 years, and 18% at 5 years. Among patients with stage IV disease, the incidence of CNS metastases was 17%, 30%, and 42%, respectively.

The median overall survival (OS) after diagnosis of CNS metastases was 0.6 years overall. The median OS was shortest for patients diagnosed with triple-negative disease (0.2 years), followed by hormone receptor (HR)-positive/HER2-negative disease (0.6 years), and HER2-positive disease (1.4 years). 

In a multivariable analysis, factors associated with an increased risk of CNS metastases were triple-negative disease (subdistribution hazard ratio [sHR], 2.31; 95% CI, 1.25–4.13) and having visceral metastasis as the first metastatic site (sHR, 1.96; 95% CI, 1.08–3.58). An older age at diagnosis was associated with a reduced risk of CNS metastases (sHR, 0.97; 95% CI, 0.96–0.99). 

These risk factors could have implications for surveillance and prognosis, the researchers wrote. “Our findings suggest there may be a role for early detection of asymptomatic [CNS metastases] in this high-risk patient population, and this strategy is currently under investigation,” they concluded.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Warren LEG, Niman SM, Remolano MC, et al. Incidence, characteristics, and management of central nervous system metastases in patients with inflammatory breast cancer. Cancer. Published online October 10, 2022. doi:10.1002/cncr.34441