Retrospective study of incidence and prognostic relevance of neurological symptoms in patients with brain metastasis from breast cancer

Existing prognostic models for breast cancer brain metastases (BCBM) overlook neurological symptoms. A retrospective analysis at the Medical University Vienna (Austria) investigated the incidicence and prognostic relevance of neurological symptoms in BCBM patients. Eighty percent (573/716) of BCBM patients in the Vienna Brain Metastasis Registry (1992-2020) presented with neurological symptoms at BCBM diagnosis. Across all BC subtypes, asymptomatic patients presented with significantly longer median overall survival compared with symptomatic patients: HR+ BC 29 versus 9 months; HER2+ BC 24 versus 12 months; en TNBC 12 versus 6 months). In multivariate analysis, presence of neurological symptoms at BCBM diagnosis was independently associated with OS from time of BM diagnosis (HR 1.6; p<0.001). The authors conclude that neurological symptom burden at BCBM diagnosis independently predicted survival.