Triple-negative and HER2-overexpressing breast cancers exhibit an elevated risk and an earlier occurrence of cerebral metastases

• Published in: European journal of cancer (1990) Vol. 45; no. 16; pp. 2792 - 2798
• Main Authors: Heitz, Florian, Harter, Philipp, Lueck, Hans-Joachim, Fissler-Eckhoff, Annette, Lorenz-Salehi, Fatemeh, Scheil-Bertram, Stefanie, Traut, Alexander, Bois, Andreas du
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.11.2009; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Brain Neoplasms - mortality; Brain Neoplasms - secondary; Breast cancer phenotypes; Breast Neoplasms - metabolism; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Cerebral metastases; Disease-Free Survival; Female; Hematology, Oncology and Palliative Medicine; HER2-overexpression; High-risk definition; Humans; Immunohistochemistry; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Phenotype; Receptor, ErbB-2 - metabolism; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Risk Factors; Triple-negative breast cancer; Tumors; Cerebral metastases; HER2-overexpression; Breast cancer phenotypes; High-risk definition; Triple-negative breast cancer; High risk; Breast disease; Central nervous system; Definition; erbB2 Gene; Gene overexpression; Breast cancer; Malignant tumor; Metastasis; Human Epidermal growth factor Receptor 2; Encephalon; Mammary gland diseases; Phenotype; Cancerology; C-Onc gene; Risk factor; Protooncogene; Cancer
• ISSN: 0959-8049; 1879-0852; 1879-0852
• DOI: 10.1016/j.ejca.2009.06.027

Evaluation of the influence of immunohistochemically defined breast cancer (BC) subtypes and other risk factors on the development of cerebral metastases (CM). Exploratory analysis of a hospital-based prospective tumour registry including all patients with primary BC treated in our EUSOMA breast unit between 1998 and 2006. The study cohort contained 2441 patients, including 284 patients (11.6%) with triple-negative (oestrogen receptor (ER), progesterone receptor (PR) and HER2-negative) and 245 patients (10.1%) with HER2-overexpressing BC subtypes. Overall, 80 patients (3.3%) developed CM within a median follow-up period of 47 months, 19 (23.8%) of them with triple-negative and 19 (23.8%) with HER2-positive tumours. Therefore, 6.7% of all patients with triple-negative and 7.8% of patients with HER2-positive breast cancer developed CM. Multivariate analysis indicated that the highest risk for CM was triple-negative breast cancer. Further independent risk factors were: HER2-overexpression, early onset BC (age < 50 years), and large tumour size (pT3/4). Among those patients developing CM, triple-negative BC showed the shortest interval between primary diagnosis and occurrence of CM with a median of 22 months, compared to 30 and 63.5 months in HER2-positive and ER+/HER2- BC, respectively. Survival after occurrence of CM did not differ among the subtypes. Patients with triple-negative or HER2-positive BC have a higher risk for CM compared with patients bearing the ER+/HER2- phenotype and develop CM earlier in the course of disease. A risk profile for CM might help adjust surveillance in high risk populations and identify patients with a need for new treatment strategies.