factos associated w improved survival in bc patients with brain mets UCSF

[Lani]

1: J Neurooncol. 2008 Apr 9 [Epub ahead of print]

Brain metastases in breast cancer: clinical and pathologic characteristics associated with improvements in survival.

Melisko ME, Moore DH, Sneed PK, De Franco J, Rugo HS.
Department of Medicine, University of California, San Francisco, 1600 Divisadero Street, 2nd Floor, San Francisco, CA, 94115, USA, mmelisko@medicine.ucsf.edu.
Background As breast cancer patients live longer with control of systemic disease, survival after the diagnosis of brain metastases (BM) also appears to be improving. Methods The authors conducted a retrospective review of 112 breast cancer patients diagnosed with BM from 1997 to 2007 and correlated clinical and pathologic characteristics including hormone receptor (HR) and Her2/neu status with outcomes. Findings Median time to BM diagnosis (TTBM) was 38 months (range, 0-204 months). TTBM was shorter for patients with HR- versus HR+ disease (median 28.8 vs. 61.2 months, P < 0.001, Wilcoxon test). No difference in TTBM was observed for patients with HER2- versus HER2+ disease (median 37.4 vs. 34.9 months, P = 0.81). Median survival after the diagnosis of BM was 14.4 months. There was no significant difference in median survival after BM diagnosis for patients with HR+ versus HR- cancers (19.9 vs. 11.0 months, P = 0.18, log rank) or for patients with HER2+ versus HER2- disease (23.1 vs. 13.3 months, P = 0.11, log rank). Survival was significantly longer in patients with stable or responding systemic disease at BM diagnosis compared to patients with progressing systemic disease (31 vs. 6.3 months, P < 0.001). Multivariate analysis revealed that HR positivity, age <50, Karnofsky Performance Score (KPS) >/=80, and stable or responding systemic disease at BM diagnosis were associated with improved survival. Interpretation Subsets of patients with breast cancer BM are surviving longer. Control of systemic disease was most strongly associated with improved outcomes, and HER2/neu overexpression did not shorten survival after the diagnosis of BM.
PMID: 18398574 [PubMed - as supplied by publisher]

[pattyz]

I put my affairs in order so long ago that I've had to update several things. Crossed off 'people to contact' since they have now passed on...too many. Added new photos. Changed dates, etc...

If I were included in a retro study my TTBM was 32 months.

I'm HR+ but was not on any hormonal.

Am HER+ and was not on Herceptin, (until mets dx.)

My systemic mets did indeed respond completely to Navelbine/Herceptin in just a few months time, and have stayed that way: NED.

But for the brain mets... (knocking wood more often now) it has been 5 yrs, 7 mos. and 7 das.

My brain has never been entirely free of mets from the get go. There have been multiple lesions continuously.
Presently around 6-8. Three of these are now just over 1cm. Progression since prior Mri.

I remain incredibly lucky to have minimal to no symptoms since 24/7 dizziness was removed with my introduction to Xeloda/Temodar in August of '05.

Tykerb was added in Dec. '07.

Ritalin has made a huge improvement in my QOL for the past several months.

It is just so hard to keep hold of 'live for the day', wondering. Wanting to plan a bit into the 'future'...but how far? With what kind of 'commitment'?

Anywho.... I'm damned lucky to still be here, because, as this retro seems to show: I've managed to stay with 'control of systemic disease' in my favor.

Wishing that for all,
with hugs,
pattyz