PMID- 14567724
OWN - NLM
STAT- MEDLINE
DCOM- 20031106
LR  - 20210527
IS  - 1543-2165 (Electronic)
IS  - 0003-9985 (Linking)
VI  - 127
IP  - 11
DP  - 2003 Nov
TI  - Her-2/neu status in breast cancer metastases to the central nervous system.
PG  - 1451-7
AB  - CONTEXT: Breast cancer is lethal when it metastasizes; one frequent site for 
      spread is the central nervous system (CNS). Approximately 15% to 30% of breast 
      cancers overexpress the protein HER-2/neu at the primary site, but there are few 
      data on whether metastases from these tumors overexpress HER-2/neu and might be 
      responsive to the potentially toxic anti-HER-2/neu immunotherapy (trastuzumab 
      [Herceptin]) used in patients with disseminated disease. OBJECTIVE: To assess CNS 
      breast cancer metastases for HER-2/neu protein overexpression by 
      immunohistochemistry and gene amplification by fluorescence in situ hybridization 
      (FISH) and to compare the status in primary and metastatic sites in the same 
      patient, whenever possible. DESIGN: Central nervous system breast cancer 
      metastases (n = 53) from 33 patients and corresponding primary breast cancer 
      specimens in a subset of these patients (n = 12) were retrospectively identified 
      in surgical pathology and autopsy databases. Fluorescence in situ hybridization 
      analysis using PathVysion probes for HER-2/neu and chromosome enumeration probe 
      17 (CEP 17) and immunohistochemistry using the c-Erb-B2 antibody (Dako A0485) 
      were compared. Immunohistochemical sections were evaluated by both visual and 
      image analysis techniques. RESULTS: Of 31 cases assessable by FISH, 26% showed 
      gene amplification. One hundred percent concordance for HER-2/neu status was 
      detected between the primary and CNS metastatic lesions in 10 of 10 patients 
      analyzed by FISH; lesser concordance was noted in 12 cases compared by 
      immunohistochemistry. In 9 patients with multiple CNS metastases, FISH showed 
      concordance among different lesions within the same patient. CONCLUSIONS: When 
      FISH is the detection method, CNS metastases accurately reflect the HER-2/neu 
      status of the primary tumor. Central nervous system metastases from breast cancer 
      received as surgical specimens can therefore be used to assess HER-2/neu status 
      in patients in whom the primary tumor is unavailable for analysis.
FAU - Lear-Kaul, Kelly C
AU  - Lear-Kaul KC
AD  - Department of Pathology, University of Colorado Health Sciences Center, Denver 
      80262, USA.
FAU - Yoon, Hye-Ryoung
AU  - Yoon HR
FAU - Kleinschmidt-DeMasters, Bette K
AU  - Kleinschmidt-DeMasters BK
FAU - McGavran, Loris
AU  - McGavran L
FAU - Singh, Meenakshi
AU  - Singh M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arch Pathol Lab Med
JT  - Archives of pathology & laboratory medicine
JID - 7607091
RN  - 0 (DNA Probes)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
MH  - Adult
MH  - Breast Neoplasms/*genetics/pathology
MH  - Carcinoma, Ductal, Breast/*genetics/*secondary
MH  - Carcinoma, Lobular/*genetics/*secondary
MH  - Central Nervous System Neoplasms/*genetics/*secondary
MH  - Chromosomes, Human, Pair 17/genetics
MH  - DNA Probes/genetics
MH  - Gene Amplification/genetics
MH  - Gene Expression Regulation, Neoplastic/genetics
MH  - Genes, erbB-2/genetics
MH  - Humans
MH  - Immunohistochemistry
MH  - In Situ Hybridization, Fluorescence
MH  - Middle Aged
MH  - Receptor, ErbB-2/*biosynthesis/immunology
MH  - Retrospective Studies
EDAT- 2003/10/22 05:00
MHDA- 2003/11/07 05:00
CRDT- 2003/10/22 05:00
PHST- 2003/10/22 05:00 [pubmed]
PHST- 2003/11/07 05:00 [medline]
PHST- 2003/10/22 05:00 [entrez]
AID - OA3091 [pii]
AID - 10.5858/2003-127-1451-NSIBCM [doi]
PST - ppublish
SO  - Arch Pathol Lab Med. 2003 Nov;127(11):1451-7. doi: 10.5858/2003-127-1451-NSIBCM.