Aim: To analyse the prognostic factors that could possibly contribute to the progression to brain metastasis in Ca Breast patients and to assess its influence on time to development.

Materials and Methods: A total of 22 carcinoma breast patients with brain metastasis who received Whole Brain Radiotherapy from January 2014 to September 2017 were retrospectively analysed. Median time to cerebral progression was analysed with respect to Stage of disease, Grade of tumour, Hormone Receptor and HER2 neu status, receipt of adjuvant chemotherapy and treatment with Trastuzumab in case of HER2 neu positive tumours. Statistical analysis was performed using Fisher Exact test.

Results: The median time to cerebral progression in patients with non–metastatic disease at presentation was 14 months (range 1–108 months). For Stage II disease, it was 27 months (range 1 – 108 months), for Stage III disease it was 9 months (p = 0.1052). The median time to cerebral progression was 22.5 months for those with Grade 2 tumours and 9 months (range 7 – 15 months) for those with Grade 3 tumours. (p = 0.772). In ER/PR+ tumours the median time to cerebral progression was 16 months whereas for those with ER/PR– tumours it was 13 months. (p = 0.1191) For the HER2 enriched subgroup, it was 8 months whereas for HER2– group the median time was 15 months. (p = 0.4766) Patients with triple negative tumours were noted to have a median time of 14 months. Among patients who received adjuvant chemotherapy their median time to cerebral progression was 14 months (range 3 – 108 months) compared to 12.5 months for those who did not receive adjuvant chemotherapy. (p=0.08) For patients with HER2+ positive tumours who received Immunotherapy with Trastuzumab, the median was 15 months compared to 8 months in those patients who did not receive Trastuzumab. (p=1.000). Additionally, in patients who had brain as the first metastatic site, the distribution of hormonal subtypes was as follows: ER+/HER2 – 1(9%), ER+/–HER2+ 5 (45%) and ER–/HER2– 5 (45%).

Conclusion: This study has enabled the identification of a subset of carcinoma breast patients who are at an increased risk for early development of brain metastasis. Those with Stage III disease, higher tumour grade, ER–, HER2 overexpressed tumours, those who did not receive adjuvant chemotherapy or those with HER2+ disease who did not receive Trastuzumab had a shorter time to development of brain metastasis.