# Sites of distant recurrence and clinical outcomes in patients with metastatic triple-negative breast cancer: high incidence of central nervous system metastases

Source: https://onco.cc/key-papers/paper-lin-tnbc-cns-metastases-dfci-cancer-2008/  
OnCo record `paper-lin-tnbc-cns-metastases-dfci-cancer-2008` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A 2008 Dana-Farber series of 116 women with metastatic triple-negative breast cancer in which 46 percent developed brain metastases before death, median survival after spread was 13.3 months and after a brain diagnosis 4.9 months.

## Summary

Lin, Claus, Sohl, Razzak and colleagues identified 116 patients treated for metastatic triple-negative breast cancer at Dana-Farber Cancer Institute between January 2000 and June 2006 from pharmacy and pathology records. Median survival from metastatic diagnosis was 13.3 months. Sixteen patients (14 percent) had central nervous system involvement at first metastatic diagnosis and 46 percent were diagnosed with central nervous system metastases before death; median survival after that diagnosis was 4.9 months, and the adjusted death rate for patients whose first presentation included a central nervous system metastasis was 3.4 times (95 percent confidence interval 1.9 to 6.1) that of others. Of 53 patients with brain metastases only 3 had stable or responding systemic disease at last follow-up, so the authors attribute the high rate to a lack of effective therapies rather than a sanctuary effect.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: tnbc-evidence
- Journal: Cancer
- Year: 2008
- DOI: 10.1002/cncr.23930
- Authors: Lin NU, Claus E, Sohl J, et al.
- Findings: Median survival from metastatic diagnosis 13.3 months (2000 to 2006).; Central nervous system metastases in 14 percent at first metastatic diagnosis and 46 percent before death; median survival after brain diagnosis 4.9 months.; Only 3 of 53 patients with brain metastases had controlled systemic disease at last follow-up.
- What it means: The 13.3-month median is the pre-immunotherapy, pre-antibody-drug conjugate benchmark against which first-line trials now reporting medians near two years are measured; the brain metastasis rate is why trials that exclude active brain disease leave the question unanswered.
- Caveats: Single-centre, retrospective, small.; Era before systematic brain imaging in asymptomatic patients.

## Sources

- Cancer 2008: https://doi.org/10.1002/cncr.23930
- PubMed: https://pubmed.ncbi.nlm.nih.gov/18833576/

## Connected records

- cancers: [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- institutions: [Dana-Farber Brigham Cancer Center](https://onco.cc/institutions/dana-farber/)
- terms: [Brain metastases (intracranial disease)](https://onco.cc/terms/brain-metastases/), [Overall survival (OS)](https://onco.cc/terms/os/)
- people: [Nancy U. Lin](https://onco.cc/people/nancy-lin/)
- bottlenecks: [Metastasis is understood least and studied last](https://onco.cc/bottlenecks/b-metastasis-biology/), [The brain: barrier and sanctuary](https://onco.cc/bottlenecks/b-brain-delivery/)
- roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/)
- ideas: [Trials that include, and report, brain metastases in triple-negative breast cancer](https://onco.cc/ideas/idea-tnbc-brain-metastasis-trials/)

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