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Receptor change-clinicopathologic analysis of matched pairs of primary and cerebral metastatic breast cancer

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Abstract

Objective

A challenge in the management of breast cancer is development of brain metastases (BM) with limited survival. In primary breast cancer, ER/PR/HER2 are important prognostic markers and are important for making effective treatment decisions. Changes in immunohistochemical markers of metastases are with unclear clinical significance, and mechanisms of resistance to endocrine therapy are an additional challenge. The aim of this retrospective study is to detect changes in immunohistochemical markers of primary and BM and to recognize if receptor change has prognostic impact.

Methods

Twenty-four consecutive primary breast cancer patients who developed BM and got surgical resection of BM were enrolled. Matched pair analyses of primary and BM were done with evaluation by immunostaining (ER/PR/HER2).

Results

A small tumor size, ductal histology and HER2+ tumors were associated with BM. Loss of ER/PR receptor positivity was observed in BM compared to primary (ER: 50.0 %/22.7 %; p = 0.004; PR: 45.8 %/9.1 %; p = n.s), respectively, and almost no change in HER2 status (>80 %; p = 0.012). Patients with ER-/PR-negative or HER2-positive primary had shorter time to recurrence than ER-/PR-positive and HER2-negative patients. Receptor change has negative prognostic impact.

Conclusion

With the observed loss of receptor positivity, therapeutic options are diminished. Identification of patients with a high risk for BM is warranted to evaluate preventive strategies.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical standards

The experiments comply with the current laws of our country. For the investigation, there exists a votum of the ethics committee (No. 171/2012R).

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, University Tübingen, Calwer Str. 7, 72070, Tübingen, Germany

    C. Bachmann, E. M. Grischke & D. Wallwiener

  2. Department of Pathology, University Tübingen, Tübingen, Germany

    A. Staebler

  3. Department of Neuropathology, University Tübingen, Tübingen, Germany

    J. Schittenhelm

Authors
  1. C. Bachmann
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  2. E. M. Grischke
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  3. A. Staebler
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  4. J. Schittenhelm
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  5. D. Wallwiener
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Corresponding author

Correspondence to C. Bachmann.

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Bachmann, C., Grischke, E.M., Staebler, A. et al. Receptor change-clinicopathologic analysis of matched pairs of primary and cerebral metastatic breast cancer. J Cancer Res Clin Oncol 139, 1909–1916 (2013). https://doi.org/10.1007/s00432-013-1511-4

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  • DOI: https://doi.org/10.1007/s00432-013-1511-4

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