HER2-low breast cancer could be associated with an increased risk of brain metastasis


GÜVEN D. C., KAYA M. B., Fedai B., ÖZDEN M., YILDIRIM H. Ç., KÖSEMEHMETOĞLU K., ...Daha Fazla

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, cilt.27, sa.2, ss.332-339, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 27 Sayı: 2
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s10147-021-02049-w
  • Dergi Adı: INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.332-339
  • Anahtar Kelimeler: Brain metastasis, Breast cancer, HER2, HER2-low, PROGNOSTIC-FACTOR, EXPRESSION, SURVIVAL, AMPLIFICATION, LEVEL
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Purpose The HER2-low breast cancer is a newly recognized entity with the clinical characteristics is yet to be defined. We hypothesized that HER2-low breast cancer could lead to an increased rate of brain metastases in patients with localized breast cancer. We tested this hypothesis in a large cohort of breast cancer patients with long follow-up. Methods We included 2686 adult breast cancer patients followed up in Hacettepe University Cancer Center. Patients with 1 + positive HER2 expression and 2 + HER2 expression with a negative FISH were categorized as HER2-low disease. We evaluated the brain metastasis risk with binary logistic regression analyses and reported odds ratios (OR) with 95% confidence intervals (CI). Results During a median 95.4 (IQR 72.6-123.1) month follow-up, 184 patients developed brain metastasis (6.9%). The brain metastases were developed in 5.1% of the patients with HER2-negative disease, 8.5% of the patients with HER2-low disease, and 10.1% of the patients with HER2-positive disease. A multivariable binary logistic regression model demonstrated an increased risk of brain metastasis in patients with HER2-low disease (OR: 1.611, 95% CI 1.055-2.460, p = 0.027) and in HER2-positive patients (OR: 1.837, 95% CI 1.308-2.580, p < 0.001). Additionally, HR + -HER2-low disease was associated with a decreased DFS compared to HR + -HER2-negative disease (p = 0.008). Conclusion In this study, we observed an increased risk of brain metastasis in localized breast cancer patients with HER2-low disease. We think that a high level of vigilance and a low threshold for brain imaging could benefit HER2-low breast cancer patients similar to the patients with HER-positive disease.