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Disease Presentation and Outcome in Very Young Patients with Brain Metastases from Breast Cancer

Aims and background Little information is available on disease presentation and treatment outcome in very young patients with brain metastases from breast cancer. Therefore, we evaluated our results in this group. Methods In our database, 7/74 breast cancer patients treated for brain metastases were <40 years old. All received whole-brain radiation therapy plus individual local or systemic measures. Results In patients with information available, tumors were poorly differentiated and metastatic to the axillary lymph nodes at primary diagnosis. All patients had extracranial metastases. Two died from their brain disease within 5 months. Five patients died from extracranial progression after 3–84 months (2 long-term survivors beyond 2 years, characterized by single brain lesions and high performance status). Conclusions Very young patients did not achieve a better outcome than intermediate age groups. Whole-brain radiation therapy plus surgery or radiosurgery provided durable CNS control in most of the patients. Improved systemic therapy appears to represent the key to a better outcome.