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Discrepancies between biomarkers of primary breast cancer and subsequent brain metastases: an international multicenter study

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Abstract

Purpose

Discordances between the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), expression between primary breast tumors and their subsequent brain metastases (BM) were investigated in breast cancer patients.

Methods

We collected retrospective data from 11 institutions in 8 countries in a predefined-standardized format. Receptor status (positive or negative) was determined according to institutional guidelines (immunohistochemically and/or fluorescence in situ hybridization). The study was subject to each institution’s ethical research committee.

Results

A total of 167 breast cancer patients with BM were included. 25 patients out of 129 with a complete receptor information from both primary tumor and BM (ER, PR, HER2) available, had a change in receptor status: 7 of 26 (27%) ER/PR-positive/HER2-negative primaries (3 gained HER2; 4 lost expression of ER/PR); 10 of 31 (32%) ER/PR-positive/HER2-positive primaries (4 lost ER/PR only; 3 lost HER2 only; 3 lost both ER/PR and HER2); one of 33 (3%) ER/PR-negative receptor/HER2-positive primaries (gained ER); and 7 of 39 (18%) triple-negative primaries (5 gained ER/PR and 2 gained HER2).

Conclusions

The majority of breast cancer patients with BM in this series had primary HER2-enriched tumors, followed by those with a triple-negative profile. One out of 5 patients had a receptor discrepancy between the primary tumor and subsequent BM. Therefore, we advise receptor status assessment of BM in all breast cancer patients with available histology as it may have significant implications for therapy.

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA

    O. Kaidar-Person & T. Zagar

  2. UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA

    O. Kaidar-Person & T. Zagar

  3. Radiation Oncology Unit, Oncology Institute, Rambam Health Care Campus, 31096, Haifa, Israel

    O. Kaidar-Person

  4. Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi-University of Florence, Florence, Italy

    I. Meattini & L. Livi

  5. Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, USA

    P. Jain & J. B. Yu

  6. Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands

    P. Bult

  7. Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA

    N. Simone & K. Ko

  8. Department of Oncology, KU Leuven – University of Leuven, 3000, Louvain, Belgium

    I. Kindts & C. Weltens

  9. Department of Radiation Oncology, University Hospitals Leuven, 3000, Louvain, Belgium

    I. Kindts & C. Weltens

  10. MediClin Robert-Janker-Clinic & Clinical Cooperation Unit of Neurooncology, University Bonn Medical Centre, Bonn, Germany

    R. Steffens & B. G. Baumert

  11. Radiotherapy and Radiosurgery Department, Humanitas Research Hospital, Rozzano, Milan, Italy

    P. Navarria

  12. Department of Radiation Oncology and Henri Mondor Breast Center. INSERM U955 E07, University of Paris-Est Créteil (UPEC), Créteil, France

    Y. Belkacemi

  13. Department of Radiation Oncology, University Hospital Virgen del Rocio, Seville, Spain

    J. Lopez-Guerra

  14. Department of Pathology, University Hospital Virgen del Rocio, Seville, Spain

    B. Vieites

  15. Oncology Institute, Davidoff Center, Rabin Medical Center, Petah-Tikva, Israel

    D. Limon & N. Kurman

  16. Department of Neurosurgery, Yale University School of Medicine, New Haven, USA

    V. Chiang

  17. Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands

    P. Poortmans

  18. Department of Radiation Oncology, Institut Curie, Paris, France

    P. Poortmans

  19. Department of Radiation Oncology, Paracelsus Clinic Osnabrueck and University of Muenster, Münster, Germany

    B. G. Baumert

Authors
  1. O. Kaidar-Person
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  2. I. Meattini
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  3. P. Jain
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  4. P. Bult
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  5. N. Simone
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  6. I. Kindts
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  7. R. Steffens
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  8. C. Weltens
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  9. P. Navarria
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  10. Y. Belkacemi
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  11. J. Lopez-Guerra
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  12. L. Livi
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  13. B. G. Baumert
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  14. B. Vieites
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  15. D. Limon
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  16. N. Kurman
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  17. K. Ko
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  18. J. B. Yu
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  19. V. Chiang
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  20. P. Poortmans
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  21. T. Zagar
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Corresponding author

Correspondence to O. Kaidar-Person.

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The authors have declared no conflicts of interest.

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Kaidar-Person, O., Meattini, I., Jain, P. et al. Discrepancies between biomarkers of primary breast cancer and subsequent brain metastases: an international multicenter study. Breast Cancer Res Treat 167, 479–483 (2018). https://doi.org/10.1007/s10549-017-4526-8

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  • DOI: https://doi.org/10.1007/s10549-017-4526-8

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