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Vol. 22, Art. 37 (pp. 540-550)    |    2021       

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Dynamics of molecular genetic markers of primary and cerebral metastatic tumor in breast cancer

North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg
Almazov National Medical Research Center, the Ministry of Health of the Russian Federation, Saint Petersburg

Brief summary

Changes in the biological subtype of tumors, namely: the status of estrogen receptors (ER), progesterone (PR), human epidermal growth factor type 2 (HER2) in patients with metastatic brain tumors caused by breast cancer, remain poorly studied. The choice of chemotherapeutic agents is based on the study of the molecular-biological features of the primary tumor. However, in a quarter of cases, discordance of cerebral metastases and primary tumors is detected, which provides an opportunity to choose more effective regimens of drug therapy. Objective. To evaluate the dynamics of molecular-genetic markers in primary and metastatic brain tumor in patients with breast cancer. Materials and Methods. The study included 22 patients whose brain metastases from breast cancer were treated surgically. An immunohistochemical assay of tumoral samples was performed to assess the expression of ER, PR, HER2. The results obtained were compared in pairs with samples from primary tumors. Results. The receptor status of the primary tumor and brain metastasis was constant in 50% of patients, while discordance in HR status was detected in 44% of cases. The rarest receptor conversions were the acquisition of HER 2+ status at 6% (n=1) and the loss of HER 2+ status at 11% (n=2). 67% of patients with HR+ primary breast tumors, receiving adjuvant anti-estrogen therapy lost expression of the target receptor in brain metastases.


Key words

breast cancer, cerebral metastases, discordance, biological heterogeneity, receptor status, HER2 status.

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