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Molecular subtype predicts incidence and prognosis of brain metastasis from breast cancer in SEER database

  • Original Article – Clinical Oncology
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Abstract

Purpose

To evaluate the impact of molecular subtype on incidence and prognosis of brain metastasis from breast cancer.

Methods

The Surveillance, Epidemiology, and End Results (SEER) 18 registry was used to select breast cancer patients from 2010 to 2014. Molecular subtypes were classified as luminal A (hormone receptor [HR]+/human epidermal growth factor receptor 2 [HER2]-), luminal B (HR+/HER2+), HER2 (HR-/HER2+), or triple negative breast cancer (TNBC) (HR-/HER2-). The incidence and prognosis of brain metastasis was evaluated according to molecular subtype.

Results

Among the 206913 breast cancer patients, the HER2 subtype showed the highest incidence of brain metastasis (1.0%). HER2 and TNBC with multiple extracranial metastases (bone, liver, and lung) showed a high incidence of brain metastasis (28.0 and 30.8%, respectively). Median survival of luminal A, luminal B, HER2, and TNBC in brain metastasis was 12, 23, 10, and 6 months (p < 0.001), and in brain metastasis without visceral metastasis was 14, 34, 17, and 8 months (p < 0.001). On multivariate analysis, the order of subtype by favorable prognosis was luminal B, luminal A, HER2, and TNBC in all brain metastasis, while for brain metastasis patients without visceral metastasis, the order was luminal B, HER2, luminal A, and TNBC.

Conclusions

Molecular subtype and visceral metastasis should be considered for prediction of prognosis for patients with brain metastasis. The patients with HER2 and TNBC cancer subtypes having visceral metastasis, close surveillance could contribute to early detection of brain metastasis and may putatively lead to improved quality of life and survival.

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Funding

This work was supported by the Grant (No. 0820010) for Cancer Control Program from Korean Ministry of Health & Welfare and SNUBH Research Fund (No. 18-2018-001 & No. 13-2018-003) to In Ah Kim.

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Authors and Affiliations

  1. Department of Radiation Oncology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea

    Yi-Jun Kim, Jae-Sung Kim & In Ah Kim

  2. Center for Precision Medicine, Seoul National University Hospital, 101 Daehak-ro, Yeongeon-dong, Jongno-gu, Seoul, 03080, Republic of Korea

    Yi-Jun Kim

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  1. Yi-Jun Kim
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  2. Jae-Sung Kim
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Correspondence to In Ah Kim.

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The authors declare no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was not required because of the retrospective nature of the study.

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Kim, YJ., Kim, JS. & Kim, I.A. Molecular subtype predicts incidence and prognosis of brain metastasis from breast cancer in SEER database. J Cancer Res Clin Oncol 144, 1803–1816 (2018). https://doi.org/10.1007/s00432-018-2697-2

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  • DOI: https://doi.org/10.1007/s00432-018-2697-2

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