Abstract
682 Background: Preliminary data indicate HER2/neu over-expression correlates with more aggressive disease, increased metastatic potential, and a poorer prognosis in patients with breast cancer. We conducted a retrospective study to evaluate whether patients with HER2/neu-positive breast cancer have an increased risk of developing brain metastases. Material and Methods: The pathology reports of 405 breast cancer patients diagnosed between April 1998 and January 2003 were reviewed. Based upon immunohistochemistry (IHC 3+) or FISH positivity, all HER2/neu-positive cases were identified and their medical charts reviewed for disease course and sites of metastases. Results: One hundred ten of the 405 patients (27%) were HER2/neu positive; sufficient oncologic history was available for 67 patients (24 premenopausal; 43 postmenopausal). Eighteen patients (27%) developed distant metastases (CI 95%: 0.177, 0.385) during follow-up lasting a median of 57 months. Brain metastases developed in 33.3% (6 out of 18)(CI 95%: 0.163, 0.562) of patients, five of who were <50 years of age; the sixth was 53 years old. The median time from diagnosis of breast cancer to development of brain metastases was 24 months (range 8 months –30 months) among the five patients <50 years old. The sixth patient found to have innumerable brain metastases in hemispheres, cerebellum and brain stem, 48 months after breast cancer diagnosis. There was a significant association (p=0.0485) between age of the patients and development of brain metastases in HER2/neu-positive breast cancer. Discussion: This small retrospective study shows that younger women with HER/2-neu-positive breast cancer may have a higher risk than reported for general metastatic breast cancer population, of developing brain metastases. This finding, if validated in larger studies, may alter treatment strategies for premenopausal patients with HER/2-neu-positive disease. No significant financial relationships to disclose.
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