From: Reuters
Published December 17, 2007 06:59 PM

HER-2-positive breast cancer tied to hormone status

By Martha Kerr

NEW YORK (Reuters Health) - HER-2-positive, hormone receptor-negative breast cancer patients have a high risk of treatment failure after chemotherapy -- and the most common site of cancer recurrence after treatment failure is the brain, Mayo Clinic researchers reported at the San Antonio Breast Cancer Symposium.

Breast cancers that are estrogen-receptor and progesterone-receptor negative are associated with the worst outcomes and require aggressive treatment right from the time of diagnosis, Dr. Laura Vallow of the Mayo Clinic in Rochester, Minnesota, told Reuters Health.

Her group reviewed records of 120 women with brain metastases after an initial diagnosis of breast cancer treated at their institution between June 1996 and November 2006. Of these women, data on the gene mutation HER-2 and the hormone receptor status were available for 83 women.

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Of the 83 women, 39 or 47 percent were HER-2-positive. Nearly all (96 percent) had received radiation therapy at the time brain metastases were diagnosed. The brain was the first site of treatment failure in 15 of the 39 women, or 38 percent, with 11 being hormone receptor-negative and 4 being hormone-positive.

HER-2-positive women with hormone receptor-positive disease had an average time from diagnosis to brain metastasis of 45 months compared with 14.5 months for HER-2-positive women with hormone-receptor negative disease.

Time to death after diagnosis of brain metastasis was 10 months for HER-2-positive, hormone receptor-positive patients compared with 3 months for HER-2-positive, hormone-receptor-negative disease.

"This isn't the whole population," Vallow pointed out in comments to Reuters Health. "This is just women with brain metastases and this is a retrospective look. These numbers look pretty terrible, but the most recent data show that disease-free survival has increased 12 percent and the risk of death has decreased 33 percent in our 2005 data."

Furthermore, "With Herceptin available now, we have a drug that can really make a difference," Vallow stressed.

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