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.