Brain metastases free survival differs between breast cancer subtypes

Abstract

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.

18F-FET PET Uptake Characteristics in Patients with Newly Diagnosed and Untreated Brain Metastasis

“…This variable 18 F-FET uptake might be attributed to different malignant melanoma metastasis subtypes, for example, amelanotic melanoma histology, which could not be assessed in all cases because of the missing histopathologic confirmation. Furthermore, general heterogeneity of brain metastases could be discussed as cause as well (28,29).…”

Progress in the Biological Understanding and Management of Breast Cancer-Associated Central Nervous System Metastases

“…The authors reported lower 15-year cumulative incidence rates of brain metastases among patients with luminal subtype breast cancer, whereas those with HER2 positive/hormone receptor negative disease and those with basal-like tumors had higher rates of 14.3% and 10.9%, respectively. Berghoff and colleagues [27] recently reported on the interval from the diagnosis of extracranial metastases to the development of brain metastases stratified by breast tumor subtype in a cohort of 213 women with metastatic breast cancer between 1996 and 2010. The authors reported a brain metastases-free survival of 14, 18, and 34 months among patients with triple negative, HER2-positive, and luminal tumors, respectively.…”

Breast Cancer Brain Metastases: Clonal Evolution in Clinical Context

“…Young age, high histologic grade, and tumour subtype are major risk factors [3,4]. BM are usually confirmed radiologically with magnetic resonance imaging (MRI), with or without gadolinium contrast enhancement, in patients who develop neurological symptoms (e.g., chronic headache, motor, cognitive or speech deficits, and seizures).…”