Breast cancers with brain metastases are more likely to be estrogen receptor negative, express the basal cytokeratin CK5/6, and overexpress HER2 or EGFR.

Full Abstract

Brain metastases (BM) from breast cancer are associated with significant morbidity and mortality. In the current study, we have examined a cohort of breast cancer patients who went on to develop BM for clinical-pathologic features and predictive markers that identify this high-risk subgroup of patients at the time of diagnosis. The primary tumors from 55 patients who developed BM were used to construct a tissue microarray. The clinical and pathologic features were recorded and the tissue microarray was stained for estrogen receptor, human epidermal growth factor receptor 2, cytokeratin 5/6, and epidermal growth factor receptor by immunohistochemistry. This cohort of patients was compared against a group of 254 patients who remain free of metastases (67 mo mean follow-up), and another cohort of 40 patients who developed mixed visceral and bone metastatic disease without brain recurrence over a similar period of time. Breast cancer patients who went on to develop BM were more likely to be <50 years old (P<0.001), and the primary tumors were more likely to be estrogen receptor negative (P<0.001) and high grade (P=0.002). The primary tumors were also more likely to express cytokeratin 5/6 (P<0.001) and epidermal growth factor receptor (P=0.001), and to overexpress human epidermal growth factor receptor 2 (P=0.001). The data presented above suggest a profile for breast cancer patients at increased risk for developing BM. Predictive factors to help identify patients with metastatic breast cancer who are at an increased risk for developing central nervous system recurrence might allow for screening of this population for early detection and treatment or for the development of targeted strategies for prevention.

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Author information

Author/s: Hicks, David G (DG); Short, Sarah M (SM); Prescott, Nichole L (NL); Tarr, Shannon M (SM); Coleman, Kara A (KA); Yoder, Brian J (BJ); Crowe, Joseph P (JP); Choueiri, Toni K (TK); Dawson, Andrea E (AE); Budd, G Thomas (GT); Tubbs, Raymond R (RR); Casey, Graham (G); Weil, Robert J (RJ);

Affiliation: Clinical and Anatomic Pathology, Cleveland Clinic Foundation, OH 44195, USA.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: The American journal of surgical pathology (Am J Surg Pathol), published in United States. (Language: eng)

Reference: 2006-Sep; vol 30 (issue 9) : pp 1097-104

Dates: Created 2006/08/25; Completed 2006/10/13; Revised 2006/11/15;

PMID: 16931954, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Brain Neoplasms - secondary
Breast Neoplasms - chemistry; pathology
Female
Gene Expression Regulation, Neoplastic
Humans
Immunohistochemistry

Immunohistochemistry
Keratins - analysis
Middle Aged
Receptor, Epidermal Growth Factor - analysis
Receptor, erbB-2 - analysis
Receptors, Estrogen - analysis

Associated Chemicals: Receptors, Estrogen (0) ; Keratins (68238-35-7) ; Receptor, Epidermal Growth Factor (EC 2.7.1.112) ; Receptor, erbB-2 (EC 2.7.1.112)

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