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According to a recent article published in the Annals of Oncology, patients with hormone-negative breast cancer who develop cancer spread to the lung as their first site of metastasis are at a significantly increased risk of developing metastasis to the brain.

Breast cancer is diagnosed in 250,000 women annually in the United States alone. Metastatic breast cancer refers to cancer that has spread from its site of origin to other sites in the body, often including vital organs such as the bone, liver, lungs or brain. The presence of brain metastasis in breast cancer is becoming more prevalent, with researchers speculating that improvement in duration of survival in these patients may result in a longer period of time for the cancer to progress. Research efforts are focused on identification of patients who are at a higher risk of developing brain metastasis, so that possible preventive efforts against spread to the brain may be implemented in this subgroup of patients.

Researchers from France recently reviewed data from two separate studies in an attempt to determine possible biologic or individual factors that may be associated with an increased risk of the development of brain metastasis in patients with a breast cancer. The patients involved in these studies had been treated with chemotherapy or hormone therapy for early breast cancer and had ultimately experienced cancer relapses. The first study included the evaluation of multiple variables of 215 patients and the second study included the evaluation of 199 patients. The only predictors of an increased risk of brain metastasis in the first study were hormone-negative breast cancer and the development of lung metastasis as the initial site of cancer spread. The second study confirmed these findings, with each study demonstrating an increased risk of the development of brain metastasis by 4-fold in patients with hormone-negative breast cancer and those with lung metastasis being the initial site of spread.

The researchers concluded that, although further studies are necessary to refine risk factors associated with an increased rate of brain metastases in patients with breast cancer, it appears that patients with hormone-negative breast cancer with an initial site of metastasis to the lung are at approximately a 4-fold increased risk of developing brain metastasis than their counterparts. Preventive treatment to the brain may help reduce this risk. Patients may wish to speak with their physician about their individual risks of brain metastasis, as well as potential risks and benefits of preventive treatment for the development of brain metastasis.

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Reference: Slimane K, Andre F, Delaloge S, et al. Risk factors for brain relapse in patients with metastatic breast cancer. Annals of Oncology. 2004;15:1640-1644.

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