Tumor phenotype and characteristics of metastatic brain involvement in breast cancer patients: Potential clinical consequences
| Authors | |
|---|---|
| Year of publication | 2009 |
| Type | Article in Proceedings |
| Conference | Journal of Clinical Oncology - supplementum |
| MU Faculty or unit | |
| Citation | |
| Web | http://meeting.ascopubs.org/cgi/content/abstract/27/15S/1026 |
| Field | Oncology and hematology |
| Keywords | breast cancer;metastasis;CNS |
| Description | Background: Central nervous system metastases (CNS) occur in about 20% of patients with breast cancer. Despite the fact that most of these patients die within a few months, substantial subgroup may survive a year or more. Methods: We performed this study on cohort of 187 breast cancer patients who developed CNS metastases to identify relations between the tumor phenotype and the incidence and characteristics of CNS dissemination, response to the local therapy and overall survival since the development of metastases in brain (OScns). Results: The incidence of monitored phenotypes and other data are included in the table. An unambiguous dependence between the tumor's phenotype and the following attributes has been proven: a) interval between the disease diagnosis and the 1st metastatic event (DFS); b) interval between the 1st metastatic event and the metastases in the CNS (TTPcns); c) characteristics of CNS dissemination. The CNS dissemination was the most extensive in patients with HER-2+ tumors in comparison with HER-2 negat. carcinomas. Surprisingly, patients with triple-negative tumors had the minimal metastatic involvement of CNS defined by size and number of lesions. Phenotype did not correlate with local response to therapy and OScns. The OScns has been significantly prolonged by neurosurgery (median 13,8 vs 2,4 months, p<0.0001) and when the effective local treatment was followed by system treatment (6,1 vs 1,9 months, p<0.0001). Conclusions: Our study has confirmed the dependence between primary tumor phenotype and the time of incidence of metastatic brain affection and character of their spread. Our results encourage the inclusion of CNS imaging examination (CT or MRI) into the regular restaging of patients with HER2 positive and triple-negative primary breast cancer, who are at high |