Conversion of ER, PR, HER2 and Ki-67 and Prognosis in breast cancer metastases to the brain

Chen Jiaxin; Zhou Jinmei; Zhang Huiqiang; Wu Xuexue; Wang Xiaobo; Zhang Shaohua; Tai Yanhong; Jiang Zefei; Wang Tao

doi:10.3389/fneur.2022.1002173

Conversion of ER, PR, HER2 and Ki-67 and Prognosis in breast cancer metastases to the brain

Front Neurol. 2022 Oct 24:13:1002173. doi: 10.3389/fneur.2022.1002173. eCollection 2022.

Authors

Chen Jiaxin¹, Zhou Jinmei², Zhang Huiqiang², Wu Xuexue², Wang Xiaobo², Zhang Shaohua², Tai Yanhong², Jiang Zefei², Wang Tao^{1

3

4}

Affiliations

¹ Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital/Chinese PLA Medical School, Beijing, China.
² Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
³ Anhui Medical University, Hefei, China.
⁴ Southern Medical University, Guangzhou, China.

Abstract

Objective: This study aimed to analyze the expression levels of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 proliferation index in the brain metastatic lesions and primary lesions in Chinese patients with breast cancer brain metastasis (BCBM) and determine the correlation between their changes and patients' survival.

Methods: A retrospective analysis was performed on patients with BCBM. The clinical characteristic of these patients was collected. The differences in the expression levels of the ER, PR, HER-2, and Ki-67 index between the primary lesions and brain lesions were evaluated, and the association between the differences and survival was analyzed.

Results: The conversion rate of anyone receptor (ER, PR, or HER2) between the primary lesions and brain metastatic lesions was 45.0% (18/40), of which the ER inconsistency rate was 25.0%, the PR inconsistency rate was 22.5%, and the HER-2 inconsistency rate was 15.0%, and the receptor conversion resulted in a subtype conversion of 27.5% (11/40). The patients with HER-2 expression discordance between the primary lesions and the brain metastatic lesions had significantly longer survival times (58.9 vs. 26.4 months, P = 0.04) after diagnosis of brain metastases.

Conclusion: In this study, 45.0% of breast cancer patients developed biomarker-conversion between the primary lesions and brain metastatic lesions, and the differences in the expression levels of the ER, PR, and HER-2, the change in Ki-67 index between the primary lesions and brain lesions may predict patients' survival.

Keywords: ER; HER-2; PR; brain metastases; breast cancer.