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05-19-2011, 12:10 AM
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#1
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Senior Member
Join Date: Mar 2006
Posts: 4,778
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Great news for those who have survived 5 years (even if stage IV)--risk of brain mets
now is tiny!!! at least according to this abstract's experience in Serbia
The risk for brain metastases in HER2 3+ BC five years after primary BC diagnosis.
Sub-category:
HER2+
Category:
Breast Cancer - HER2/ER
Meeting:
2011 ASCO Annual Meeting
Abstract No:
e11091
Citation:
J Clin Oncol 29: 2011 (suppl; abstr e11091)
Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2011 Annual Meeting but not presented at the Meeting, can be found online only.
The publication-only abstracts are not included in the print or USB versions of the ASCO Annual Meeting Proceedings Part I, but they are citable to the Journal of Clinical Oncology as a supplement (see citation on left).
Author(s): Z. Tomasevic, Z. Kovac, Z. Milovanovic, D. Gavrilovic; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro
Abstract Disclosures
Abstract:
Background: More than 30% of HER2 3+ BC develops brain metastases (BM) eventually, usually in the first 2-3 years after BC diagnosis. Risk for distant metastases in HER2 3+ BC remains for many years, but there are no data regarding the long term risk for BM The aim of this analysis is to is to explore whether risk for late BM, defined as BM relapse after 5 years of diagnosis) differs between patients with HER2 3+ and HER2- BC. Methods: Between January 2007-January 2011, 133 consecutive BC BM pts were identified. Patients were evaluated for age, ER/PGR/HER2 status, time to BM and BM as first relapse site according to HER2 status. BM as a first relapse site also includes BM diagnosed within 2 months after metastases in other organs developed. Results: Median age was 49 years (range 25-79); HER2 status (HercepTest, Dako) was known for 118 pts (88.7%) and they are considered for this analysis. HER 2 3+ was confirmed in 40 (34 %), HER2 0-2+ (2+ confirmed by CISH) in 78 (66%) and triple negative status in 19 (16 %) pts. Median time to BM in HER2 negative pts was 36 months (range 0-252).Median time to BM in HER2 3+ BC was 25 months (range 0-96); 39/40 (97,5%) HER2 3+ pts developed BM within 0-60 months, and only 1 MBC pt developed BM 96 months after BC diagnosis. That unique MBC patient, treated with trastuzumab for 8 years developed infra-tentorial BM as a terminal event. Conclusions: There is a striking difference in late BM development between HER2 3+ and HER2 negative BC. For some reason, HER2 3+ BC does not or extremely rarely metastasize to the brain 5 yrs after BC diagnosis, even if metastases in the other organ sites are present. It seems that if HER2 3+ pt survive > 5 yrs without metastases, BM development is highly unlikely. Risk for BM in HER2 negative pts is retained for many years (up to 21 yrs), even as a first relapse site. These results could be important for potential future prophylactic BM strategies.
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05-19-2011, 03:20 AM
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#2
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Senior Member
Join Date: May 2010
Posts: 432
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Re: Great news for those who have survived 5 years (even if stage IV)--risk of brain
Thanks very much Lani.You have given me a boost
__________________
PBK
huband of Hema
Metstatic Breast Cancer Stage 4
Left breast cauliflower 25x20cm
ossousmetstatis in vertbrae secondaries L4=L5secondary
nodules in both liver lobes secondary
Diagnosed 10th March 2010
ER/PR-ve
Her 2 neu +++
Taxotrne Zylotec started 16th March
Herceptin added 5th April.9th Herceptin over on 20th Sep '10.Started on Tykerb and Xeloda on 22nd Oct2010TYKERB 4 TAB A DAY XELODA 4 TAB A DAY ONE WEEK ON ONE WEEK OFFZoletrust infusion every 4 months.Lesion in Brain 3D CRT Radiation started on 1st Feb'12 for 20 days ,5 days a week for 4 weeks.Devloped a small lump in breast.Xeloda stopped from 11th April '12.On Taxol.After 3 cycles of Taxol Taxol stopped.Back to Xeloda regime from 3rd July
Herceptin started again on 27th Dec 2012.Xeloda stopped Navelbin added on 7th February 2013.Now on Tykerb Herceptin and Navelbin
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05-19-2011, 04:17 PM
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#3
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Senior Member
Join Date: Sep 2005
Location: Newton, MA
Posts: 951
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Re: Great news for those who have survived 5 years (even if stage IV)--risk of brain
I am one of the unlucky ones. I was diagnosed in May 1998 IIB/IIIA (couldn't decide) and developed brain mets in May 2004. At least I'm still here and am currently NED.
Barbara H.
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05-20-2011, 12:31 PM
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#4
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Senior Member
Join Date: Nov 2005
Location: Ireland
Posts: 3,463
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Re: Great news for those who have survived 5 years (even if stage IV)--risk of brain
Thanks Lani, this cheered me too and gave me one less thing to worry about!
Barbara, NED for so long after brain mets is wonderful and many more years to you!
__________________
Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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05-21-2011, 06:25 PM
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#5
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Senior Member
Join Date: May 2010
Location: Melbourne, Australia
Posts: 434
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Re: Great news for those who have survived 5 years (even if stage IV)--risk of brain
Thanks Lani-I'm hoping risk is similar in Australia to Serbia! I really appreciate your posts.
Trish
__________________
5/2004 (R) 30mm bre gr3 infiltrating ductal ca 16/18nodes er (2+) pr (3+) HER2 (3+)
6/2004 6 cycles(FEC), Oct 40 rads, Tamoxifen
5/2006 oopherectomy, Arimedex
12/2006 liver mets largest 9cm
1/2007 Herceptin,
3/2007 Taxol + Herc
1/2008 Herc alone
4/2008 Multiple bone mets,Zometa
7/2008 Herc + Gemcitabine
8/2008 Herc+Navelbine/vinoralbine
10/2008 Herc+Carboplatin+Taxol
12/2008 Tykerb+Xeloda
2/2010 Herceptin + trial drug
5/2010 Herceptin+Tykerb
8/2010 Tykerb+Abraxane
9/2010 Abraxane
12/2010 Abraxane+Tyk+Herc
4/2011 Tyk+Herc+Femara
6/2011 Liver and bone mets prog.Abraxane continue Herceptin,Tykerb,Femara and Zometa
8/2011 Probable liver progression and increased neuropathy. Xeloda with Tyk+Herc. Zometa 6 weekly.
9/2011 Liver progression,TM +++. Cyclophosphamide and Methotrexate metro Herc Zometa
10/2011 liver mets prog.Herc, 3 Tykerb +2mg decodron daily,Zometa
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06-01-2011, 09:28 PM
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#6
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Senior Member
Join Date: Feb 2006
Posts: 1,014
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Re: Great news for those who have survived 5 years (even if stage IV)--risk of brain
This is good to hear. Being now 5 years out NED and stage IV, it's good to hear I don't have to obsess quite so much about my brain. ..sherryg
__________________
Sherry
Diagnosed: December , 2005 at age 44
13+ positive lymph nodes
Stage IV , Her2+, 2 small mets to lungsChemo Started: Jan, 2006
4 months Taxotere, Xeloda, Hercepin
NED since April 2006!!
36 Rads to follow with weekly Herceptin indefinately
8 years NED now
Scans every year
Life is not about avoiding the thunderstorms, it's about learning to dance in the rain!
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06-02-2011, 12:29 PM
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#7
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Senior Member
Join Date: Aug 2009
Location: Moultrie, GA
Posts: 431
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Re: Great news for those who have survived 5 years (even if stage IV)--risk of brain
Lani, thank you so much for posting this. I am about to make my three year mark and have a six month exam in a couple of weeks. I have begun to worry about bms for some crazy reason. This has given me some reassurance. (Of course, I know there are no guarantees!)
__________________
Diagnosed: 7/25/08 ~ age 63, no family history
Surgery: 8/14/08 Bilateral mastectomy; tumor left breast, node dissection; right prophylactic with expanders: 1/12/10 latisimuss dorsi flap on left side: 9/22/10 implants in
Pathology Report: ER/PR-; HER2+ (3+); Grade 3, StageIII; 3cm tumor plus 21/21 lymph nodes positive; 5cm DCIS
Chemo: A/C; Taxol/Herceptin/Tykerb; phase II study at Mayo adding Tykerb for early stage
Radiation: 25 rads
Vaccine: Walter Reed GP2/AE37 vaccine study ~ last booster 9/17/2012
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06-02-2011, 01:49 PM
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#8
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Senior Member
Join Date: Jan 2007
Location: Thornhill, Ontario
Canada
Posts: 2,320
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Re: Great news for those who have survived 5 years (even if stage IV)--risk of brain
Great to hear Lani. I'll be 5 years out Oct. 2011, so hopefully I'll be in this club!!
all the best
caya
__________________
ER90%+/PR 50%+/HER 2+
1.7 cm and 1.0 cm.
Stage 1, grade 2, Node Negative (16 nodes tested)
MRM Dec.18/06
3 x FEC, 3 x Taxotere
Herceptin - every 3 weeks for a year, finished May 8/08
Tamoxifen - 2 1/2 years
Femara - Jan. 1, 2010 - July 18, 2012
BRCA1/BRCA2 Negative
Dignosed 10/16/06, age 48 , premenopausal
Mild lymphedema diagnosed June 2009 - breast surgeon and lymph. therapist think it's completely reversible - hope so.
Reclast infusion January 2012
Oopherectomy October 2013
15 Years NED!!
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