Absence of brain metastases in late relapse of HER2-overexpressed breast carcinoma

Abstract

1014 Background: The incidence of brain metastases (BM) in HER2 3+ breast carcinoma (BC) reported in the literature is between 20–34%, usually during first 2 years of metastatic disease. However, there are limited data about BM as a late relapse in HER2 over expressed BC. Therefore, the aim of this paper is to analyze BM as a late relapse in patients with HER2 over expressed and non over expressed BC. Late relapse is defined as relapse at least five years after initial diagnose. Methods: Medical documentation of all patients with late relapse was analyzed for DFI and development of BM at any time point during metastatic disease. IHH (Herceptest DAKO) HER-2 status was determined on the archived pathological specimens of the primary BC Results: Among 1,256 BC patients diagnosed during 6 months period (June-November, 2005 at the Institute for Oncology and Radiology of Serbia), 111 (8,8%) were diagnosed with late relapse. Median age at the initial diagnose was 50 years (33–74), median time to relapse was 7 years, (range 5–29). Archived pathological specimens is identified for 64% of patients and HER-2 status of the primary BC was: 76,3% 0 or1+; 9,5% 2+; and 14,2% 3+; Only 5 patients have been treated with trastuzumab in metastatic setting. None of the patients with HER2 3+ BC had BM either as a first relapse site or later during metastatic disease. Two patients who had late relapse of HER2 0+ BC, developed BM as a first site of relapse, after 5 and 7 years of the initial diagnose. Conclusions: Although the number of presented patients is small, the absence of BM in late relapse of HER2 3+ BC, could represent the specific biological characteristic of HER 2 3+ carcinomas to develop BM mostly in the early course of metastatic disease. No significant financial relationships to disclose.