Survival among women with triple receptor-negative breast cancer and brain metastases

Dawood, Shaheenah; Broglio, Kristine; Esteva, Francisco J.; Yang, Wei Tse; Kau, Shu Wan; Islam, Rabiul; Albarracin, Constance T.; Yu, Tse-Kuan; Green, M.; Hortobágyi, G. N.; González-Angulo, Ana M.

doi:10.1093/annonc/mdn682

Cited by 148 publications

(84 citation statements)

References 23 publications

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“…Brain metastases has been thought to be more common with TNBC patients risk being 6-46% [20][21][22]of those experiencing metastatic disease, we had one patient with multiple brain metastases who received palliative radiotherapy but later succumbed to death within 4 months of diagnosing brain metastases.…”

Section: Discussionmentioning

confidence: 99%

Triple Negative Breast Cancer - Our Experience and Review

Krishnamurthy

Poornima

Challa

et al. 2012

Indian J Surg Oncol

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Triple negative breast cancer (TNBC) constitutes 10-25% of patients with breast cancer. TNBC is an aggressive phenotype affecting younger age groups and has poor prognosis. We retrospectively analysed 50 triple negative breast cancer patients attending our outpatient department among 270 breast cancer patients. The incidence of TNBC was 18.5%, and most of them were premenopausal 56% (28/50) with mean age was 46.66±13.87 (Range 28-72 years). Most of them had Invasive ductal cancer 94% (47/50) and were high grade (Grade 3−96%)(48/50). Five patients presented with metastatic disease (2 patients only Skeletal, 1 patient with Skeletal and Lung, 1 patient with Lung and 1 patient with Liver) and 7 patients developed recurrence (all 7 had chest wall recurrence, 3 had supraclavicular lymph node recurrence, 2 had skeletal metastases and 1 had developed brain metastases) during follow up. The mean disease free survival was 15 months (Range 3-58 months) and overall survival was 20.14 months (Range 5-70 months). Fifty six percent (28/50) of patients were premenopausal and mean age of presentation was 46.66±13.87 years (Range 28-72 years). Ten percent (5/50) presented with metastatic disease and 15% (7/45) developed metastases during follow up. Five patients (10%) died during follow up. Hence, Triple negative breast cancer is aggressive, with rapid progression leading to mortality in younger patients.

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Section: Discussionmentioning

confidence: 99%

Triple Negative Breast Cancer - Our Experience and Review

Krishnamurthy

Poornima

Challa

et al. 2012

Indian J Surg Oncol

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“…In accordance with this finding, recent reports have demonstrated that molecular subtypes of breast cancer other than HER2-positive disease (eg, triple-negative tumors) may be related to an increased risk of CNS metastases independently of treatment-related factors. 46,47 The current study is inherently limited by its observational nature. Because of this, it is supposed that the treatment with trastuzumab was not randomly allocated among HER2-positive patients but was determined depending on the patient status.…”

Section: Discussionmentioning

confidence: 99%

Multifactorial central nervous system recurrence susceptibility in patients with HER2‐positive breast cancer

Musolino¹,

Ciccolallo²,

Panebianco³

et al. 2010

Cancer

120

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BACKGROUND: A series of retrospective studies have reported that patients with human epidermal growth factor receptor 2(HER2)-positive breast cancer are at a greater risk of central nervous system (CNS) metastases. Trastuzumab, which does not cross the blood-brain barrier, has been associated with this increased risk. METHODS: The authors evaluated incidence, survival, and risk factors for CNS metastases in the incident breast cancer population systematically collected by the Parma Province Cancer Registry over the 4-year period between 2004 and 2007. RESULTS: A total of 1458 patients with a diagnosis of stage I to III invasive breast cancer were analyzed for study purposes. At a median follow-up of 4.1 years, CNS events were observed in 1.3% and 5% of HER2-negative patients and HER2-positive patients, respectively (P < .0001). The administration of trastuzumab either as adjuvant therapy or for metastatic disease was associated with a significantly increased risk of CNS involvement at first disease recurrence and after first extracranial recurrence, respectively. According to multivariate analysis, HER2-positive status and trastuzumab treatment, high Ki-67 index, and hormone receptor negativity remained independent risk factors for the development of CNS metastasis. CONCLUSIONS: To the authors' knowledge, this is the first population-based cancer registry study analyzing factors associated with CNS recurrence in a general population of newly diagnosed breast cancer patients with known HER2 status. The data from the current study provide evidence that patients with HER2-positive breast cancer have a significantly higher incidence of CNS metastasis after treatment with trastuzumab. Improvements in systemic control and overall survival associated with trastuzumab-based therapy may lead to an ''unmasking'' of CNS disease recurrence that would otherwise remain clinically silent before a patient's death.

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“…(3,4) However, the incidence and survival from BM in this cohort has yet to be well-defined. (7)(8)(9) We noted that, among women with TNBC, BM occurs …”

Section: Clinical Outcome According To Breast Cancer Subtypesmentioning

confidence: 99%

Clinical Outcomes in Patients with Triple-negative Breast Cancer and Brain Metastases

Kwon

Kim

et al. 2010

J Breast Cancer

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Purpose: Patients with triple-negative breast cancer (TNBC) are known to carry an increased risk of distant metastasis and poor survival. The principal objective of this study was to investigate survival after brain metastases in patients with TNBC. Methods: The authors retrospectively evaluated clinical data obtained from 66 patients who had been diagnosed with breast cancer and brain metastasis from 2003 to 2009. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth receptor-2 (HER2) statuses were determined via immunohistochemical staining. TNBCs were defined as those that were ER-negative, PR-negative, and HER2-negative. The time interval from initial diagnosis to brain metastasis and overall survival after brain metastasis was evaluated via the Kaplan-Meier method. Results: Twenty four (40.0%) of 60 patients were diagnosed with TNBC. The clinicopathologic characteristics did not differ between the TNBC and non-TNBC patients. The disease-free survival durations of the TNBC and non-TNBC subjects were 17.9 and 25.6 months, respectively (p=0.135). The time intervals from initial diagnosis to brain metastasis were 25.5 and 43.7 months, respectively (p=0.027). The time intervals from distant metastasis to brain metastasis were 8.4 and 19.5 months, respectively (p=0.006). Overall survival durations from brain metastasis to death were 4.3 and 7.6 months, respectively (p=0.046). Conclusion: Patients with TNBC were more likely to develop brain metastasis earlier, and exhibit poor overall survival. Triple receptor status may be utilized as a prognostic marker for breast cancer patients with brain metastasis.

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Survival among women with triple receptor-negative breast cancer and brain metastases

Abstract: In this single-institutional study, patients with nonmetastatic triple receptor-negative breast tumors have a high early incidence of brain metastases associated with poor survival and maybe an ideal cohort to target brain metastases preventive strategies.

Cited by 148 publications

References 23 publications

Triple Negative Breast Cancer - Our Experience and Review

Triple Negative Breast Cancer - Our Experience and Review

Multifactorial central nervous system recurrence susceptibility in patients with HER2‐positive breast cancer

Clinical Outcomes in Patients with Triple-negative Breast Cancer and Brain Metastases

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