Hormonal receptor, human epidermal growth factor receptor-2, and Ki67 discordance between primary breast cancer and paired metastases: clinical impact.

As hormone receptor and human epidermal growth factor receptor-2 (HER-2) expression in primary breast tumors frequently differs from that of paired metastases, we first evaluated the discordance rate (DR) of estrogen receptor (ER), progesterone receptor (PgR), HER-2, and Ki67 in breast cancer patients and then assessed the discordance effect on prognosis. Of 145 cases reviewed, 120 with samples available from both primary tumors and paired metastases were included in the study. For each receptor, the DR was calculated as the proportion of discordant cases with respect to the total number of patients. A change in ER status was observed in 19 cases (DR 16.4%), while PgR status was modified in 48 cases (DR 41.7%). HER-2 was altered in 21 cases (DR 17.5%), and Ki67 in 33 patients (DR 38.8%). Patients with Ki67 <20% had a significantly higher postrecurrence survival (PRS) compared to patients with Ki67 ≥20% (p = 0.0006). Patients with ER-positive tumors showed a trend towards higher PRS (p = 0.064) compared to ER-negative patients. No differences in PRS were seen among patients with altered PgR or HER2 status. Changes in the cell biology of breast cancer metastasis would seem to occur and biopsy could potentially guide the choice of treatment and provide useful information on prognosis.

Ibrahim T ，Farolfi A ，Scarpi E ，Mercatali L ，Medri L ，Ricci M ，Nanni O ，Serra L ，Amadori D ... -  《-》

Discordant expression of hormone receptors and HER2 in breast cancer. A retrospective comparison of primary tumors with paired metachronous recurrences or metastases.

Arapantoni-Dadioti P ，Valavanis C ，Gavressea T ，Tzaida O ，Trihia H ，Lekka I ... -  《Journal of BUON》

Retrospective analysis of risk factors for central nervous system metastases in operable breast cancer: effects of biologic subtype and Ki67 overexpression on survival.

Identifying factors that predispose patients to central nervous system (CNS) metastases may hasten disease detection and improve treatment outcomes. We reviewed the records of patients who were diagnosed with clinical stage I-III primary breast cancer at the National Cancer Center Hospital East from 2003 to 2005. Cox proportional hazard models were fitted to reveal risk factors for CNS metastases. The median follow-up period after the operation was 53.5 months. Among the 591 identified patients with breast cancer, 76 experienced a relapse. Seventeen patients developed CNS metastases. Multivariate analysis indicated that the triple negative (TN) subtype (hazard ratio = 5.5) and a high Ki67 labeling index (LI; hazard ratio = 3.9) were associated with a higher risk for CNS metastases. At 4 years, the TN subtype was associated with significantly worse overall and disease-free survival rates and a higher cumulative incidence of CNS metastases compared with hormone receptor-positive/ human epidermal growth factor receptor-2-negative tumors. Breast cancers with a Ki67 LI ≥30% were also associated with lower overall and disease-free survival rates and a higher cumulative incidence of CNS metastases compared with cancers with a Ki67 LI <30%. TN or Ki67-overexpressing breast cancer produced earlier CNS metastases and lower disease-free and overall survival rates.

Ishihara M ，Mukai H ，Nagai S ，Onozawa M ，Nihei K ，Shimada T ，Wada N ... -  《-》

Primary breast cancer phenotypes associated with propensity for central nervous system metastases.

Tham YL ，Sexton K ，Kramer R ，Hilsenbeck S ，Elledge R ... -  《CANCER》

[Prognostic value of estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 in node positive breast cancer patients treated by mastectomy].

Wang SL ，Li YX ，Song YW ，Wang WH ，Jin J ，Liu YP ，Liu XF ，Yu ZH ... -  《-》