Dear Editor,
I want to congratulate Cagney and their colleagues [1] in which they investigated intracranial recurrence patterns of brain metastases from breast cancer after brain-directed radiation to facilitate subtype-specific management paradigms. They reported a strong association between breast cancer subtype and intracranial recurrence patterns after brain-directed radiation, particularly local progression for HER2+ and distant progression for TNBC patients. However, the authors did not consider ER(+)/HER2(+) and ER-/HER2(+) as a different subtype. Analysis of HER2+ metastatic breast cancer has often been performed disregarding the ER status of the disease. Recent study examined the metastatic pattern and prognosis of both ER+/HER2+ and ER−/HER2+ 86,093 breast cancer patients [2]. This large study showed that patients with ER+/HER2+ and ER−/HER2+ breast cancers had different metastatic patterns and patients with ER−/HER2+ breast cancer had worse prognosis. Taken all together, ER(+)/HER2(+) and ER−/HER2(+) breast cancers might have different intracranial recurrence patterns after brain-directed radiation for brain metastases. This issue merits further investigation.
References
Cagney DN, Lamba N, Montoya S, Li P et al (2019) Breast cancer subtype and intracranial recurrence patterns after brain-directed radiation for brain metastases. Breast Cancer Res Treat. https://doi.org/10.1007/s10549-019-05236-6
Arciero CA, Guo Y, Jiang R et al (2019) ER(+)/HER2(+) breast cancer has different metastatic patterns and better survival than ER-/HER2(+) breast cancer. Clin Breast Cancer 1:1–10. https://doi.org/10.1016/j.clbc.2019.02.001
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Altundag, K. ER(+)/HER2(+) and ER−/HER2(+) breast cancers might have different intracranial recurrence patterns after brain-directed radiation for brain metastases. Breast Cancer Res Treat 177, 233 (2019). https://doi.org/10.1007/s10549-019-05257-1
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DOI: https://doi.org/10.1007/s10549-019-05257-1