Abstract | BACKGROUND: METHODS: The authors evaluated incidence, survival, and risk factors for CNS metastases in the incident breast cancer population systematically collected by the Parma Province Cancer Registry over the 4-year period between 2004 and 2007. RESULTS: A total of 1458 patients with a diagnosis of stage I to III invasive breast cancer were analyzed for study purposes. At a median follow-up of 4.1 years, CNS events were observed in 1.3% and 5% of HER2-negative patients and HER2-positive patients, respectively (P < .0001). The administration of trastuzumab either as adjuvant therapy or for metastatic disease was associated with a significantly increased risk of CNS involvement at first disease recurrence and after first extracranial recurrence, respectively. According to multivariate analysis, HER2-positive status and trastuzumab treatment, high Ki-67 index, and hormone receptor negativity remained independent risk factors for the development of CNS metastasis. CONCLUSIONS: To the authors' knowledge, this is the first population-based cancer registry study analyzing factors associated with CNS recurrence in a general population of newly diagnosed breast cancer patients with known HER2 status. The data from the current study provide evidence that patients with HER2-positive breast cancer have a significantly higher incidence of CNS metastasis after treatment with trastuzumab. Improvements in systemic control and overall survival associated with trastuzumab-based therapy may lead to an "unmasking" of CNS disease recurrence that would otherwise remain clinically silent before a patient's death.
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Authors | Antonino Musolino, Laura Ciccolallo, Michele Panebianco, Elisa Fontana, Daniele Zanoni, Cecilia Bozzetti, Maria Michiara, Enrico Maria Silini, Andrea Ardizzoni |
Journal | Cancer
(Cancer)
Vol. 117
Issue 9
Pg. 1837-46
(May 01 2011)
ISSN: 0008-543X [Print] United States |
PMID | 21509760
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2010 American Cancer Society. |
Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Humanized
- Trastuzumab
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal
(adverse effects, therapeutic use)
- Antibodies, Monoclonal, Humanized
- Breast Neoplasms
(genetics, mortality, pathology)
- Central Nervous System Neoplasms
(epidemiology, secondary)
- Female
- Genes, erbB-2
- Humans
- Incidence
- Middle Aged
- Population Surveillance
- Prognosis
- Recurrence
- Registries
- Risk Factors
- Trastuzumab
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