Brain metastases as late breast cancer relapse. Single institution experience and review of the literature.
OBJECTIVE
Approximately 40% of HER2-positive breast cancer patients will develop brain metastases, usually during the first 2-3 years following initial diagnosis and up to 2 years after overt metastatic spread. However, there are no data about brain metastases development as a late disease relapse. In addition, there are no data whether the high incidence of brain metastases is maintained in patients with HER2 overexpression even in late brain metastases. The aim of this paper was to determine the incidence of brain metastases and the HER2 status in patients who developed late relapse, at least 5 years after the initial diagnosis.


METHODS
Among 384 consecutive breast cancer patients with late relapse, only 8 developed brain metastases. Archival pathological specimens of the primary tumors of those 8 patients were tested by immunohistochemistry (IHC) for HER2 status.


RESULTS
The incidence of late brain metastases was 2% (8/384). None of these patients had HER2 3+ primary breast cancer.


CONCLUSIONS
This study shows that the risk for brain metastases in HER2 3+ breast cancer patients is very low or might be even absent as a late relapse. Absence of late brain metastases in HER2 3+ breast cancer might be attributed to specific biological characteristics of HER2 3+ carcinomas to develop brain metastases mostly in the early course of metastatic disease.
Tomasevic
Z
Z
Daily Chemotherapy hospital, Department of Radiotherapy, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia. zoricant@ncrc.ac.yu
Radosevic-Jelic
Lj
Lj
Jovanovic
D
D
Milovanovic
Z
Z
Tomasevic
Z M
ZM
Jelic
S
S
Borojevic
N
N
D000328:Adult; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000453:epidemiology / Q000556:secondary; D018275:Carcinoma, Lobular / Q000188:drug therapy / Q000453:epidemiology / Q000556:secondary; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D015994:Incidence; D008499:Medical Records; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D016896:Treatment Outcome
D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human