Geburtshilfe Frauenheilkd 2014; 74 - PO_Onko07_04
DOI: 10.1055/s-0034-1388444

HER1- HER4- Clinicopathologic analysis of matched pairs: Primary and cerebral metastases of breast cancer

C Bachmann 1, G Brockhoff 2, EM Grischke 1, A Staebler 3, J Schittenhelm 4, D Wallwiener 1
  • 1Uni-Frauenklinik, Tübingen, Germany
  • 2Unifrauenklinik, Regensburg, Germany
  • 3Uni-Frauenklinik Tübingen, Pathologie, Tübingen, Germany
  • 4Uni-Frauenklinik Tübingen, Neuropathologie, Tübingen, Germany

Background and Aim: HER2overexpression is a prognostic and predictive factor for development of CNS metastases (BM) in primary breast cancer. Studies have shown that the immunophenotype of distant breast cancer metastases may be different from that of primary tumour, leading to inappropriate choice of systemic treatment. A number of studies have demonstrated that HER3overexpression is associated with poor prognosis and HER4 is more related with a favourable prognosis in breast cancer. Aim is to detect if there is receptor change for ER/PR and HER1 – 4 status in matched pairs of BM and primary.

Methods: 24 consecutive patients with surgical resected BM of breast cancer were enrolled. All patients were treated at the Department of Gynecology, university Tübingen, Germany and got first diagnosis of primary breast cancer between 2001 – 2008. Matched pair analysis of primary and BM were performed with IHC staining for ER/PR/HER1 – 4. HER2 in situ hybridization was done in cases of IHCconversion or IHC showed 2+.

Results: There was almost 100% coincidence of HER2status in BM and primary and a high discordance for ER/PRstatus. Her2positive breast cancer patients had higher risk getting BM (52%: Her2 positive) compared to Her2negative patients. In almost all cases BM showed loss of receptor positivity (ER/PR). The comparison of HER1/3/4 status of primary and BM showed inhomogeneous results.

Conclusion: The HER1 – 4status of primary and BM showed inhomogenous results. The impact of Her3/4 expression on prognosis has to be investigated in larger studies. Definite conclusions for HER3/4 expression could not yet be drawn.