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Model of Graesslin et al for Predicting the Risk of Brain Metastases in a Woman with Metastatic Breast Cancer

Description

Graesslin et al developed a nomogram based on a model to predict brain metastasis in a woman with metastatic breast cancer. This can help to identify a patient who should be evaluated for intracranial disease. The patients are from M.D. Anderson Cancer Center, Centre Hospitalier Universitaire in Reims, University Pierre et Marie Curie in Paris and the University of Alberta in Edmonton.


 

Patient selection: metastastic breast cancer without known brain metastasis

 

Parameters:

(1) age in years

(2) histologic grade of the breast cancer

(3) status of the breast markers (ER, PR, HER2/neu)

(4) interval between diagnosis and first metastasis in months

(5) number of non-brain metastatic sites

 

points for age from 10 to 100 =

= MAX(0,111.1 - (1.11 * (age in years)))

 

Interval

Points

< 20 months

73

20 to 100 months

88.98 - (0.8867 * (months))

> 100 months

0

 

 

Parameter

Finding

Points

histologic grade

Grade 1 or 2

0

 

Grade 3

24

status of breast markers

HER2/neu positive

59

 

HER2 negative, ER and PR negative

19

 

HER2 negative, ER or PR positive

0

number of non-brain metastases

1

0

 

2 or more

34

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 300

• The higher the score the greater the risk of a brain metastasis

 

Total Score

Probability of Brain Metastasis

< 100

< 5%

100 to 280

(0.001181 * ((points)^2)) - (0.1976 * (points)) + 12.99

> 280

> 50%

 


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