Frequency Survey of Brain Metastases and Its Associated Factors Among Iranian Women with Breast Cancer: A Cross-sectional Study in Tehran City

Abstract

Background: Brain metastases are serious complication of breast cancer (BC) that poses a critical management challenge. Hence, this study aimed to evaluate clinical findings, the status of hormonal receptors, and their correlation with brain metastasis among patients with BC. Materials and Methods: This cross-sectional study was performed on women with BC that was newly diagnosed with brain metastasis from 2020 to 2023. Also, hormonal receptor status (such as p53, estrogen receptor ER, progesterone receptor PR, human epidermal growth factor2 HER2), histopathological type of BC, duration of disease, type of treatment, local cerebral invasions, and initial presentations were recorded. A P-value less than 0.05 was considered as statistical significance. Results: Of a total of 302 patients, 49 (16.2%) patients had brain metastasis. The mean age of patients was 45.21 +/- 8.3 years, which was significantly lower in patients with metastasis (45.96 +/- 11.31 vs. 51.13 +/- 12.61 years, P=0.008). There was a significant association between the duration of disease in patients with and without brain metastasis (2.76 +/- 1.03 vs. 5.55 +/- 3.32 years, P=0.002). Also, the most prevalent histopathological type of BC was invasive ductal carcinoma (IDC). Headache was the most common clinical presentation among patients with brain metastasis. In addition, the most and the least common positive receptors among patients with metastasis were Ki -67 (93.87%) and PR (55.1%), respectively. Compared to patients without metastasis, HER2-positive and P53-positive receptors were markedly associated with brain metastasis (P=0.03 and P=0.021, respectively). However, there was no significant association between treatment methods and metastasis status. Conclusion: Patients with younger age, IDC, and positivity of HER2 and P53 receptors were at an increased risk of developing brain metastases.