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Clinical features and course of brain metastases in triple-negative breast cancer: comparison with human epidermal growth factor receptor 2-positive and other type at single institution in Korea

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Abstract

The incidences and clinical aggressiveness of intracranial metastases have not been as well characterized in patients with triple-negative (TN) breast cancer as in patients with human epidermal growth factor 2-positive (HER2+) breast cancer. Patients diagnosed with brain metastases from primary breast cancer, as determined by computed tomography and/or magnetic resonance imaging, at Asan Medical Center from January 1990 to July 2006 were identified and classified into three subtypes: TN, HER2+, and other. The clinical features and outcomes of these three groups were compared. Of the 7,872 patients diagnosed with primary breast cancer, 198 developed brain metastases; of these, 61 patients with unknown estrogen receptor, progesterone receptor, and HER2 status were excluded. Of the remaining 137 patients, 44 (32%) were classified as TN, 69 (50%) as HER2+, and 24 (18%) as other. Clinical parameters, including performance status and previous adjuvant chemotherapy and/or radiotherapy, were well balanced among groups, except that earlier staged tumors (I and II) were more prevalent in the TN than in the HER2+ and other (59 vs. 36 vs. 38%, P = 0.01). At a median follow-up of 99 months, the median times from initial diagnosis to brain metastasis (20 vs. 32 vs. 45 months, P = 0.01) and to first distant metastasis at any site (16 vs. 23 vs. 23 months, P = 0.005) were significantly shorter in TN than in the HER2+ and other. Median overall survival (OS) from primary cancer diagnosis was significantly shorter in the TN than in the HER2+ and other (31 vs. 39 vs. 57 months, P = 0.02), but survival after brain metastasis was similar (5.9 vs. 5.2 vs. 8.8 months, P = 0.31). Compared with other breast cancer phenotypes, TN breast cancer was characterized by earlier brain and other distant metastases and shorter OS, despite a higher proportion of tumors diagnosed at early stages.

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Authors and Affiliations

  1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-gu, Seoul, 138-736, Korea

    Geundoo Jang, Sung Sook Lee, Jin-Hee Ahn, Kyung Hae Jung, Hyunjoo Lee & Sung-Bae Kim

  2. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Gyungyub Gong

  3. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Hak-Hee Kim

  4. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Seung Do Ahn

  5. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Byung Ho Son & Sei-Hyun Ahn

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  1. Geundoo Jang
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  2. Sung Sook Lee
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  3. Jin-Hee Ahn
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  4. Kyung Hae Jung
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  7. Hak-Hee Kim
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  8. Seung Do Ahn
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  9. Byung Ho Son
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  10. Sei-Hyun Ahn
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  11. Sung-Bae Kim
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Correspondence to Sung-Bae Kim.

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Jang, G., Lee, S.S., Ahn, JH. et al. Clinical features and course of brain metastases in triple-negative breast cancer: comparison with human epidermal growth factor receptor 2-positive and other type at single institution in Korea. Breast Cancer Res Treat 128, 171–177 (2011). https://doi.org/10.1007/s10549-011-1526-y

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  • DOI: https://doi.org/10.1007/s10549-011-1526-y

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