Risk factors for brain metastasis as a first site of disease recurrence in patients with HER2 positive early stage breast cancer treated with adjuvant trastuzumab

Breast. 2016 Feb;25:22-6. doi: 10.1016/j.breast.2015.11.006. Epub 2015 Dec 20.

Abstract

Purpose: The aim of this study was to determine risk factors for brain metastasis as the first site of disease recurrence in patients with HER2-positive early-stage breast cancer (EBC) who received adjuvant trastuzumab.

Methods: Medical records of 588 female patients who received 52-week adjuvant trastuzumab from 14 centers were evaluated. Cumulative incidence functions for brain metastasis as the first site of disease recurrence and the effect of covariates on brain metastasis were evaluated in a competing risk analysis and competing risks regression, respectively.

Results: Median follow-up time was 36 months. Cumulative incidence of brain metastasis at 12 months and 24 months was 0.6% and 2%, respectively. HER2-enriched subtype (ER- and PR-) tumor (p = 0.001, RR: 3.4, 95% CI: 1.33-8.71) and stage 3 disease (p = 0.0032, RR: 9.39, 95% CI: 1.33-8.71) were significant risk factors for development of brain metastasis as the first site of recurrence.

Conclusions: In patients with HER2 positive EBC who received adjuvant trastuzumab, HER2-enriched subtype (ER- and PR-) tumor and stage 3 disease were associated with increased risk of brain metastasis as the first site of disease recurrence.

Keywords: Adjuvant therapy; Brain metastasis; Breast cancer; Trastuzumab.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Brain Neoplasms / epidemiology
  • Brain Neoplasms / secondary*
  • Breast Neoplasms / chemistry*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / pathology*
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Incidence
  • Logistic Models
  • Mastectomy
  • Mastectomy, Segmental
  • Middle Aged
  • Neoplasm Staging
  • Receptor, ErbB-2 / analysis*
  • Retrospective Studies
  • Risk Factors
  • Trastuzumab / therapeutic use
  • Young Adult

Substances

  • Antineoplastic Agents
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab