Triple-negative breast cancer with brain metastases: a comparison between basal-like and non-basal-like biological subtypes

J Neurooncol. 2011 Dec;105(3):547-53. doi: 10.1007/s11060-011-0616-3. Epub 2011 Jun 9.

Abstract

The aim of this study was to divide the group of triple-negative breast cancer patients with brain metastases into basal-like and non-basal-like biological subtypes in order to compare clinical features and survival rates in those two groups. A comprehensive analysis of 111 consecutive triple-negative breast cancer patients with brain metastases treated in the years 2003-2009 was performed. In 75 patients, immunohistochemistry was used as a surrogate of microarray in order to evaluate the expression of three basal markers: cytokeratin 5/6 (CK 5/6), EGFR/HER1 and c-KIT. The basal-like (ER/PgR/HER2-negative, CK5/6positive and/or HER1-positive) and non-basal-like (ER/PgR/HER2-negative, CK5/6-negative, HER1-negative) subsets were selected. Clinical features and survivals were compared in both groups. In the group of 111 triple-negative breast cancer patients, median DFS, OS and survival from brain metastases were 20, 29 and 4 months, respectively. In 75 patients who were evaluable for basal markers, median DFS, OS and survival from brain metastases were 18, 26 and 3.2 months, respectively. In the basal-like subtype, the survival rates were 15, 26 and 3 months, respectively, and in the non-basal-like subtypes, they were 20, 30 and 2.8 months, respectively. No statistically significant differences in survivals were detected between the basal-like and non-basal-like biological subtypes. Factors influencing survival from brain metastases were: Karnofsky performance status (KPS), the status of extracranial disease and age. Biological markers differentiating triple-negative group into basal-like and non-basal-like subtype (CK 5/6, HER1, c-KIT) had no influence on survival. In patients with triple-negative breast cancer and brain metastases, well-known clinical, but not molecular, features correlated with survival.

Publication types

  • Comparative Study

MeSH terms

  • Biomarkers, Tumor / analysis
  • Brain Neoplasms / metabolism
  • Brain Neoplasms / mortality*
  • Brain Neoplasms / secondary*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology*
  • ErbB Receptors / analysis
  • Female
  • Humans
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Keratin-5 / analysis
  • Keratin-6 / analysis
  • Middle Aged
  • Neoplasm Staging
  • Oligonucleotide Array Sequence Analysis
  • Proportional Hazards Models
  • Proto-Oncogene Proteins c-kit / analysis
  • Receptor, ErbB-2 / biosynthesis
  • Receptors, Estrogen / biosynthesis
  • Receptors, Progesterone / biosynthesis

Substances

  • Biomarkers, Tumor
  • Keratin-5
  • Keratin-6
  • Receptors, Estrogen
  • Receptors, Progesterone
  • EGFR protein, human
  • ERBB2 protein, human
  • ErbB Receptors
  • Proto-Oncogene Proteins c-kit
  • Receptor, ErbB-2