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Breast Cancer Research
Published in: Breast Cancer Research 1/2008

Open Access 01-02-2008 | Research article

Breast cancer subtypes and survival in patients with brain metastases

Authors: Byung-Ho Nam, Sun Young Kim, Hye-Sook Han, Youngmee Kwon, Keun Seok Lee, Tae Hyun Kim, Jungsil Ro

Published in: Breast Cancer Research | Issue 1/2008

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Abstract

Introduction

Brain metastases (BM) occur in up to one third of patients with metastatic breast cancer (MBC), whose incidences and prognoses by breast cancer subtypes in BM have not been well delineated.

Methods

Retrospective survival analyses were performed in 126 BM patients from 805 MBC patients treated at the National Cancer Center between August 2001 and April 2006, according to clinical characteristics, breast cancer subtypes, and receipt of trastuzumab. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth receptor-2 (HER2) statuses were tested by immunohistochemical (IHC) staining, and HER2 FISH analysis conducted for IHC 2+.

Results

The proportion of HER2+/ER- (29% vs 16%) and triple-negative (37% vs 25%) tumors was higher in the 126 BM patients than those without BM. While median survival after recurrence was longer in patients with luminal A disease (median survival of luminal A vs luminal B vs HER2+/ER- vs triple-negative: p = 0.0246; 39.6 vs 27.4 vs 20.9 vs 15.5 months), survival was shorter from BM to death in luminal A and triple negatives (median survival: p = 0.0113; 4.0 vs 9.2 vs 5.0 vs 3.4 months). Receipt of trastuzumab after BM was a significant variable for survival in HER2+ patients. Multivariate analyses identified ER-negative, HER2-negative, or triple-negative, as well as older age, presence of leptomeningeal disease, and three or more extracranial disease sites, as poor prognostic factors for survival after BM.

Conclusion

MBC patients who developed BM had higher proportions of triple-negative and HER2+/ER- tumor status. Triple receptor status is a useful prognostic marker for predicting survival after BM in metastatic breast cancer patients.
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Literature
1.
Tsukada Y, Fouad A, Pickren JW, Lane WW: Central nervous system metastasis from breast carcinoma. Autopsy study. Cancer. 1983, 52: 2349-2354. 10.1002/1097-0142(19831215)52:12<2349::AID-CNCR2820521231>3.0.CO;2-B.CrossRefPubMed
2.
Lin NU, Bellon JR, Winer EP: CNS metastases in breast cancer. J Clin Oncol. 2004, 22: 3608-3617. 10.1200/JCO.2004.01.175.CrossRefPubMed
3.
Mahmoud-Ahmed AS, Suh JH, Lee SY, Crownover RL, Barnett GH: Results of whole brain radiotherapy in patients with brain metastases from breast cancer: a retrospective study. Int J Radiat Oncol Biol Phys. 2002, 54: 810-817.CrossRefPubMed
4.
Evans AJ, James JJ, Cornford EJ, Chan SY, Burrell HC, Pinder SE, Gutteridge E, Robertson JF, Hornbuckle J, Cheung KL: Brain metastases from breast cancer: identification of a high-risk group. Clin Oncol (R Coll Radiol). 2004, 16: 345-349.CrossRef
5.
Gonzalez-Angulo AM, Cristofanilli M, Strom EA, Buzdar AU, Kau SW, Broglio KR, Smith TL, Hortobagyi GN: Central nervous system metastases in patients with high-risk breast carcinoma after multimodality treatment. Cancer. 2004, 101: 1760-1766. 10.1002/cncr.20530.CrossRefPubMed
6.
Hicks DG, Short SM, Prescott NL, Tarr SM, Coleman KA, Yoder BJ, Crowe JP, Choueiri TK, Dawson AE, Budd GT, Tubbs RR, Casey G, Weil RJ: Breast cancers with brain metastases are more likely to be estrogen receptor negative, express the basal cytokeratin CK5/6, and overexpress HER2 or EGFR. Am J Surg Pathol. 2006, 30: 1097-1104.CrossRefPubMed
7.
Slimane K, Andre F, Delaloge S, Dunant A, Perez A, Grenier J, Massard C, Spielmann M: Risk factors for brain relapse in patients with metastatic breast cancer. Ann Oncol. 2004, 15: 1640-1644. 10.1093/annonc/mdh432.CrossRefPubMed
8.
Ryberg M, Nielsen D, Osterlind K, Andersen PK, Skovsgaard T, Dombernowsky P: Predictors of central nervous system metastasis in patients with metastatic breast cancer. A competing risk analysis of 579 patients treated with epirubicin-based chemotherapy. Breast Cancer Res Treat. 2005, 91: 217-225. 10.1007/s10549-005-0323-x.CrossRefPubMed
9.
Miller KD, Weathers T, Haney LG, Timmerman R, Dickler M, Shen J, Sledge GW: Occult central nervous system involvement in patients with metastatic breast cancer: prevalence, predictive factors and impact on overall survival. Ann Oncol. 2003, 14: 1072-1077. 10.1093/annonc/mdg300.CrossRefPubMed
10.
Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, Fluge Ø, Pergamenschikov A, Williams C, Zhu SX, Lønning PE, Børresen-Dale A-L, Brown PO, Botstein D: Molecular portraits of human breast tumours. Nature. 2000, 406: 747-752. 10.1038/35021093.CrossRefPubMed
11.
Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, Hastie T, Eisen MB, van de Rijn M, Jeffrey SS, Thorsen T, Quist H, Matese JC, Brown PO, Botstein D, Lønning PE, Børresen-Dale A-L: Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2001, 98: 10869-10874. 10.1073/pnas.191367098.CrossRefPubMedPubMedCentral
12.
Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K, Karaca G, Troester MA, Tse CK, Edmiston S, Deming SL, Geradts J, Cheang MCU, Nielsen TO, Moorman PG, Earp HS, Millikan RC: Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA. 2006, 295: 2492-2502. 10.1001/jama.295.21.2492.CrossRefPubMed
13.
Regitnig P, Reiner A, Dinges HP, Hofler G, Muller-Holzner E, Lax SF, Obrist P, Rudas M, Quehenberger F: Quality assurance for detection of estrogen and progesterone receptors by immunohistochemistry in Austrian pathology laboratories. Virchows Arch. 2002, 441: 328-334. 10.1007/s00428-002-0646-5.CrossRefPubMed
14.
Jacobs TW, Gown AM, Yaziji H, Barnes MJ, Schnitt SJ: Specificity of HercepTest in determining HER-2/neu status of breast cancers using the United States Food and Drug Administration-approved scoring system. J Clin Oncol. 1999, 17: 1983-1987.CrossRefPubMed
15.
Bria E, Cuppone F, Fornier M, Nistico C, Carlini P, Milella M, Sperduti I, Terzoli E, Cognetti F, Giannarelli D: Cardiotoxicity and incidence of brain metastases after adjuvant trastuzumab for early breast cancer: the dark side of the moon? A meta-analysis of the randomized trials. Breast Cancer Res Treat. 2007
16.
Gori S, Rimondini S, De Angelis V, Colozza M, Bisagni G, Moretti G, Sidoni A, Basurto C, Aristei C, Anastasi P, Crino L: Central nervous system metastases in HER-2 positive metastatic breast cancer patients treated with trastuzumab: incidence, survival, and risk factors. Oncologist. 2007, 12: 766-773. 10.1634/theoncologist.12-7-766.CrossRefPubMed
17.
Cleator S, Heller W, Coombes RC: Triple-negative breast cancer: therapeutic options. Lancet Oncol. 2007, 8: 235-244. 10.1016/S1470-2045(07)70074-8.CrossRefPubMed
18.
Fulford LG, Reis-Filho JS, Ryder K, Jones C, Gillett CE, Hanby A, Easton D, Lakhani SR: Basal-like grade III invasive ductal carcinoma of the breast: patterns of metastasis and long-term survival. Breast Cancer Res. 2007, 9: R4-10.1186/bcr1636.CrossRefPubMedPubMedCentral
19.
Engel J, Eckel R, Aydemir U, Aydemir S, Kerr J, Schlesinger-Raab A, Dirschedl P, Holzel D: Determinants and prognoses of locoregional and distant progression in breast cancer. Int J Radiat Oncol Biol Phys. 2003, 55: 1186-1195.CrossRefPubMed
20.
Kirsch DG, Ledezma CJ, Mathews CS, Bhan AK, Ancukiewicz M, Hochberg FH, Loeffler JS: Survival after brain metastases from breast cancer in the trastuzumab era. J Clin Oncol. 2005, 23: 2114-2116. 10.1200/JCO.2005.05.249.CrossRefPubMed
21.
Bendell JC, Domchek SM, Burstein HJ, Harris L, Younger J, Kuter I, Bunnell C, Rue M, Gelman R, Winer E: Central nervous system metastases in women who receive trastuzumab-based therapy for metastatic breast carcinoma. Cancer. 2003, 97: 2972-2977. 10.1002/cncr.11436.CrossRefPubMed
Metadata
Title
Breast cancer subtypes and survival in patients with brain metastases
Authors
Byung-Ho Nam
Sun Young Kim
Hye-Sook Han
Youngmee Kwon
Keun Seok Lee
Tae Hyun Kim
Jungsil Ro
Publication date
01-02-2008
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 1/2008
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/bcr1870

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