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Journal Article
Brain metastases free survival differs between breast cancer subtypes
2012
Overview
Background:
Brain metastases (BM) are frequently diagnosed in patients with HER-2-positive metastatic breast cancer; in addition, an increasing incidence was reported for triple-negative tumours. We aimed to compare brain metastases free survival (BMFS) of breast cancer subtypes in patients treated between 1996 until 2010.
Methods:
Brain metastases free survival was measured as the interval from diagnosis of extracranial breast cancer metastases until diagnosis of BM. HER-2 status was analysed by immunohistochemistry and reanalysed by fluorescent
in situ
hybridisation if a score of 2+ was gained. Oestrogen-receptor (ER) and progesterone-receptor (PgR) status was analysed by immunohistochemistry. Brain metastases free survival curves were estimated with the Kaplan–Meier method and compared with the log-rank test.
Results:
Data of 213 patients (46 luminal/124 HER-2/43 triple-negative subtype) with BM from breast cancer were available for the analysis. Brain metastases free survival differed significantly between breast cancer subtypes. Median BMFS in triple-negative tumours was 14 months (95% CI: 11.34–16.66) compared with 18 months (95% CI: 14.46–21.54) in HER-2-positive tumours (
P
=0.001) and 34 months (95% CI: 23.71–44.29) in luminal tumours (
P
=0.001), respectively. In HER-2-positive patients, co-positivity for ER and HER-2 prolonged BMFS (26
vs
15 m;
P
=0.033); in luminal tumours, co-expression of ER and PgR was not significantly associated with BMFS. Brain metastases free survival in patients with lung metastases was significantly shorter (17
vs
21 months;
P
=0.014).
Conclusion:
Brain metastases free survival in triple-negative breast cancer, as well as in HER-2-positive/ER-negative, is significantly shorter compared with HER-2/ER co-positive or luminal tumours, mirroring the aggressiveness of these breast cancer subtypes.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adult
/ Aged
/ Biological and medical sciences
/ Biomarkers, Tumor - metabolism
/ Biomedical and Life Sciences
/ Breast Neoplasms - epidemiology
/ Breast Neoplasms - metabolism
/ Breast Neoplasms - pathology
/ Female
/ Humans
/ In Situ Hybridization, Fluorescence
/ Oncology
/ Receptor, ErbB-2 - metabolism
/ Receptors, Estrogen - metabolism
/ Receptors, Progesterone - metabolism
/ Tumors
