28P - Her 2 3+ locally advanced breast cancer and brain metastases
|Date||08 May 2014|
|Session||Welcome reception and Poster Walk|
Breast Cancer, Locally Advanced
|Citation||Annals of Oncology (2014) 25 (suppl_1): i8-i16. 10.1093/annonc/mdu066|
Z.I. Tomasevic1, Z.M. Tomasevic2, Z. Kovac3
Incidence of brain metastases (BM) as a first metastatic site in patients with Her2 3+ locally advanced breast cancer (LABC) is not well explored. Patterns of first metastatic site in LABC could be important for future diagnostic and treatment planning. The aim of this study was to analyze the percentage of patients with BM as a first metastatic site, during or after treatment for Her2 3+ LABC.
Patients and methods:
From January 2007 to December 2013, 242 BC patients with BM were registered in a prospective database. BC histology and initial disease stage was known for all patients, Her2 status was known for 90% (Her2 3 + : 31,7 %), estrogen/progesterone receptor status were known for 95% (negative:∼65%)
In the whole group of patients with BM, 48% has been treated for LABC (116/242), and almost half of them (52/116: 45%), developed BM as a first metastatic site. Her2 3+ LABC was confirmed in 51/116 (44%) patients, and in that subgroup, 20/51 (39%) had BM as a first metastatic site. 18 patients received trastuzumab as a part of neoadjuvant and/or postoperative treatment before BM diagnosis. Time to BM as a first metastatic site from Her2 3+ LABC diagnosis was median 18 (range 1–42) mean 25,2 months. OS after BM diagnosis was median 6 months (range 2–84+), mean 12 months. Four patients (4/20: 20%), without extra-cranial or BM progression, had median survival of 19.5 months (range13–84+). In these patients, BM were diagnosed upon mild CNS symptom occurrence (headache only).
Because currently BM cannot be predicted or prevented, brain screening is not routinely recommended. Our results suggest that patients with Her2 3+ LABC have a high risk for BM as a first metastatic site (43%). Brain screening seems a reasonable option in that subgroup, because some patients might achieve long-term disease control after early brain-directed treatment.
All authors have declared no conflicts of interest.