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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2023; 42(02): e121-e126
DOI: 10.1055/s-0043-1769779
Original Article | Artigo Original

Brain Metastasis is Associated with Tumor Size, Nodal Status, and c-erbB-2 Expression in Invasive Breast Carcinoma

A metástase cerebral está associada com tamanho tumoral, status nodal e expressão de c-erbB-2 no carcinoma invasivo de mama
Eduardo Cambruzzi 
1   Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
2   Departament of Pathology, Hospital Santa Rita, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
3   Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil
4   Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil
5   Universidade do Vale do Rio dos Sino - UNISINOS, São Leopoldo, RS, Brasil
,
Natália Brandelli Zandoná
3   Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil
,
José Nathan Andrade Müller da Silva
3   Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil
,
Gabriella Bezerra Cortês Nascimento
3   Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil
,
Mateus Scarabelot Medeiros
3   Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil
› Author Affiliations Funding The authors declare they have received no funding pertaining to the present study.
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Abstract

Introduction According to the World Health Organization (WHO) classification, invasive breast carcinoma (IBC) of no special type (IBC-NST) is the second most common primary site of central nervous system metastases, affecting 15% to 30% of patients. Brain metastasis originating from IBC is associated with patient age, tumor size, and axillary lymph node status. Loss of expression of hormone receptors and c-erbB-2 amplification are frequent findings in patients who develop brain metastasis. Radiological studies of the central nervous system are carried out only in patients presenting with neurological signs or symptoms during the clinical follow-up.

Objective To evaluate the associations of clinical and pathological findings with brain metastasis in breast cancer.

Materials and Methods The sample comprised 73 patients with breast cancer who underwent mastectomy with lymph node resection. The following variables were evaluated: tumor size, histological grade, nodal state, expression of estrogen and progesterone receptors and c-erbB-2, and presence of brain metastasis.

Results The histopathological findings associated with brain metastasis in patients with IBC were tumor size (p = 0.03), presence of nodal metastasis (p = 0.045), and c-erbB-2 expression (p = 0.012).

Conclusion The assessment of specific pathological findings in breast carcinoma can help identify risk factors and/or clinical parameters associated with the development of brain metastasis.

Resumo

Introdução O carcinoma invasivo de mama (CIM) de tipo não especial, segundo a classificação da Organização Mundial de Saúde, é o segundo sítio primário mais comum de metástases do sistema nervoso central, afetando de 15% a 30% das pacientes. A metástase cerebral originada de CIM está associada à idade do paciente, tamanho do tumor, estado nodal axilar e perfil imuno-histoquímico do local primário. A perda da expressão dos receptores hormonais e a amplificação do c-erbB-2 são achados frequentes em pacientes que desenvolvem metástase cerebral. Estudos radiológicos do sistema nervoso central são realizados apenas em pacientes que apresentam sinais ou sintomas neurológicos durante o acompanhamento clínico.

Objetivo Este estudo teve como objetivo avaliar associações de achados clínicos e patológicos com metástase cerebral em IBC. Método: A amostra foi composta por 73 pacientes com CIM submetidas à mastectomia e ressecção nodal axilar. Foram avaliadas as seguintes variáveis: tamanho do tumor, grau histológico, estado nodal, expressão de receptores de estrogênio e progesterona e c-erbB-2 e presença de metástase cerebral tratada por ressecção cirúrgica.

Resultados Os achados histopatológicos associados à metástase cerebral em pacientes com IBC foram tamanho do tumor (p = 0,03), presença de metástase nodal (p = 0,045) e expressão de c-erbB-2 (p = 0,012).

Conclusão A avaliação de achados patológicos específicos no IBC pode ajudar a identificar fatores de risco e/ou parâmetros clínicos associados ao desenvolvimento de metástase cerebral.

Keywords

central nervous system - carcinoma - breast - tumor metastasis - pathology - prognosis

Palavras-chave

sistema nervoso central - carcinoma - seios - metástase tumoral - patologia - prognóstico

Authors' Contributions

EC: work design, scientific review, and writing of the manuscript MSM: work design and scientific review; and NBZ, JNAMS, and GBCN: data collection.


Ethics Declaration Statement

Approval was obtained from the Ethics Committee of Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brazil. The procedures used in the present study adhere to the tenets of the Declaration of Helsinki.




Publication History

Received: 30 July 2022

Accepted: 24 January 2023

Article published online:
28 June 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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