Immunophenotype Profile of Breast Carcinoma Brain Metastases in Comparison to Their Breast Primaries
Reda S Saad, Ahmed El-sayed, Ahmed Shehata, Miral Mashhour, Wedad Hanna. Sunnybrook Health Sciences Centre, Toronto, Canada
Background: Brain metastases (BM) arising from breast cancer correlates with a poor prognosis. Identification of tumor characteristics associated with breast cancer brain metastases (BCBM) could help identify patients at risk. There is few information available on hormonal status in breast carcinoma metastatic to brain.
Design: Computer search identified patients with breast cancer (BC) brain metastases who were diagnosed between 2000 and 2010. Hormonal receptors and Her2/neu were performed on both primary and metastatic brain tumors. Survival and disease recurrence patterns were evaluated by age, hormonal and Her2/neu status using the Kaplan-Meier method and Cox regression analysis.
Results: Our study included 130 patients with BC brain metastases with mean age 47±9 years. The median age at diagnosis of primary breast carcinoma and brain metastasis was 43 and 47 years, respectively. The median interval between both diagnoses in this subgroup was 32 months. Metastatic tumor was located in cerebellum in 60/130 (46%), cerebrum in 57/130 (44%) and 13/130 (10%) in vertebral column. Primary breast carcinoma demonstrated high-grade in 87/130 (67%), intermediate grade in 39/130 (30%) and low grade 4/130 (3%). Primary breast carcinoma was ER positive in 56/130 (43%) (5 low positive and 51 strongly positive), PR positive in 46/130 (35%) (3 low positive and 43 strong positive), and Her2/neu was positive in 41/130 (32%). ER change from positive to negative in 7/130 (5%) cases and from negative to positive 4/130 (3%), PR status from positive to negative in 10/130 (8%) and negative to positive 2/130 (2%). None of our cases shows any change of Her2/neu status between primary and metastatic tumor. Tumor grade correlate negatively with ER, and PR status, but not with Her2/neu status. Her2/neu was correlated with age (younger age show positive results) (P< 0.05). Only Her2/neu status shows significant correlation with patient survival.
Conclusions: Expression of antigens commonly associated with breast carcinoma does not differ significantly between the primary tumor and the corresponding brain metastases. No specific immunoprofile identifies breast carcinomas that develop brain metastases, although Her2/neu status was associated with poor survival.
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 39, Wednesday Morning