her2+ breast cancer associated with higher risk of brain mets--but better survival

[Lani]

after brain mets

and it was mostly her2+er- tumors which were associated with brain mets

http://www.medicalnewstoday.com/articles/98852.php

http://breast-cancer-research.com/content/10/1/R20



Breast Cancer Research
Volume 10
Issue 1


Research article
Breast cancer subtypes and survival in patients with brain metastases
Byung-Ho Nam , Sun Young Kim , Hye-Suk Han , Youngmee Kwon , Keun Seok Lee , Tae Hyun Kim and Jungsil Ro

Breast Cancer Research 2008, 10:R20doi:10.1186/bcr1870

Published: 28 February 2008
Abstract (provisional)

Introduction
Brain metastases (BM) occur in up to one third of patients with metastatic breast cancer (MBC), whose incidences and prognoses by breast cancer subtypes in BM have not been well delineated.

Methods
Retrospective survival analyses were performed in 126 BM patients from 805 MBC patients treated at the National Cancer Center between August 2001 and April 2006, according to clinical characteristics, breast cancer subtypes, and receipt of trastuzumab. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth receptor-2 (HER2) statuses were tested by immunohistochemical (IHC) staining, and HER2 FISH analysis conducted for IHC 2+.

Results
The proportion of HER2+/ER- (29% vs 16%) and triple-negative (37% vs 25%) tumors was higher in the 126 BM patients than those without BM. While median survival after recurrence was longer in patients with luminal A disease (median survival of luminal A vs luminal B vs HER2+/ER- vs triple-negative: p = 0.0246; 39.6 vs 27.4 vs 20.9 vs 15.5 months), survival was shorter from BM to death in luminal A and triple negatives (median survival: p = 0.0113; 4.0 vs 9.2 vs 5.0 vs 3.4 months). Receipt of trastuzumab after BM was a significant variable for survival in HER2+ patients. Multivariate analyses identified ER-negative, HER2-negative, or triple-negative, as well as older age, presence of leptomeningeal disease, and three or more extracranial disease sites, as poor prognostic factors for survival after BM.

Conclusions
MBC patients who developed BM had higher proportions of triple-negative and HER2+/ER- tumor status. Triple receptor status is a useful prognostic marker for predicting survival after BM in metastatic breast cancer patients.