Clinical-pathological patterns and prognosis of young women with breast cancer brain metastases: a single-center retrospective study.

Purpose: Breast cancer (BC) is the most frequent cancer among women and the second leading cause of central nervous system (CNS) metastases. While the epidemiology of CNS metastases from BC has been well described, little is known about the treatment patterns and outcomes of young women < 40 years of age with BC that is metastatic to the CNS.

Methods: In this retrospective analysis, we identified patients with metastatic breast cancer (MBC) to the CNS who were treated at the Sunnybrook Odette Cancer Center, Toronto, Canada between 2008 and 2018. Young women were defined as those who were < 40 years of age at the time of diagnosis of CNS metastases. Descriptive statistics were completed, and survival analyses performed.

Results: Similar clinical and pathological characteristics were observed among young and older women with CNS metastases. However, young women were significantly more likely to develop leptomeningeal metastatic disease (LMD) than older women (39.6% vs. 22.3%, p = 0.004). Additionally, young women were significantly more likely to be re-treated for CNS metastases (43.4% vs. 24.5%, p = 0.003). There was no significant difference in median brain-specific progression-free survival (bs-PFS) (log-rank p = 0.35) or overall survival (OS) (log-rank p value = 0.52) between young and older women.

Conclusions: Women < 40 years of age were more likely to develop LMD than women ≥ 40 years of age. Although young women were also more likely to be re-treated for progression of CNS metastases, their bs-PFS and OS were not inferior to those ≥ 40 years of age.