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. 2008;10(1):R20.
doi: 10.1186/bcr1870. Epub 2008 Feb 28.

Breast cancer subtypes and survival in patients with brain metastases

Byung-Ho Nam  1 , Sun Young Kim, Hye-Sook Han, Youngmee Kwon, Keun Seok Lee, Tae Hyun Kim, Jungsil Ro
Affiliations

Breast cancer subtypes and survival in patients with brain metastases

Byung-Ho Nam et al. Breast Cancer Res. 2008.

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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Figures

Figure 1
Figure 1
Kaplan-Meier survival curves according to triple receptor status (a) from recurrence to death of all patients (n = 126), (b) from brain metastasis to death of all patients (n = 126), (c) from recurrence to death, excluding patients who received trastuzumab after BM (n = 105), and (d) from brain metastasis to death, excluding patients who received trastuzumab after BM (n = 105).
Figure 2
Figure 2
Kaplan-Meier curves of survival from brain metastasis according to HER2 status and receipt of trastuzumab.
See this image and copyright information in PMC

Comment in

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