Brain metastases in women with HER2-positive breast cancer.

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chocomousse
chocomousse Member Posts: 157
edited October 2017 in HER2+ (Positive) Breast Cancer

http://neurosciencenews.com/breast-cancer-brain-61...


Summary: Researchers have discovered the mechanism behind the development of brain metastases in women with HER2-positive breast cancer.

Source: City of Hope.

Breast cancer cells express brain proteins to avoid natural defenses.

Ninety percent of cancer deaths are from cancer spread. Breast cancer patients, for example, typically do not die because cancer returns in their breast, they die because it spreads to other parts of their body. The most dangerous of which is the brain. Approximately 40 percent of all women with HER2-positive breast cancer will develop brain metastases. Now City of Hope researchers have found how this happens.

Breast cancer cells wrap themselves in reelin — a protein typically found only in the brain — that allows the cells to disguise themselves as "friend and not foe," avoiding a system in the brain designed to detect enemy cells. From these disguised cells, new deadly brain tumors form.

"More women than ever are surviving breast cancer only to die from breast tumors growing in their brains years after they've been declared cancer-free," said City of Hope dual trained neurosurgeon and scientist Rahul Jandial, M.D., Ph.D., who led the study available online and slated for the upcoming print publication of the Clinical & Experimental Metastasis, the journal for the Metastases Research Society. "I wanted to understand why women with HER2-positive breast cancer (around 20 percent of all breast cancers) have higher rates of brain metastases than women with other breast cancer subtypes and in turn, find their biological Achilles heel to develop new medicines."

After performing brain surgery, Jandial and his team took leftover tissue samples and compared them to breast cancer tissue removed from mastectomies in the same women. They compared the expression of proteins and found that reelin expression was low in primary breast cancer tissue. However, its expression was significantly higher in HER2-positive breast cancer metastasizing to the brain.

Image shows a brain.

Understanding these mechanisms is an important step in developing new therapies to treat brain cancers — especially for metastatic cancers. NeuroscienceNews.com image is for illustrative purposes only.

"The cells are essentially able to act as spies that look like citizens," said Jandial. "They release a mesh of protein and escape the brain's natural defense weapons, causing tumors to grow in the brain."

Understanding these mechanisms is an important step in developing new therapies to treat brain cancers — especially for metastatic cancers. Metastases are responsible for 90 percent of all cancer deaths, and patients diagnosed with brain metastases only have a 20 percent chance of surviving a year after diagnosis.

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  • wyattsmom
    wyattsmom Member Posts: 33
    edited March 2017

    Thank you for your post chocomousse. I am looking for people who are ER-/PR- /HER2+ that have had a recurrence, metastasis to other areas and/or brain. I am curious how many people with our type of cancer develop metastases after clear NED diagnosis, and what were your symptoms, tests that found it and ultimate outcome.

    I was diagnosed with stageIII A or B... ER-/PR- HER2+ breast cancer in 2009. Left breast. Chemo, lumpectomy, node removal, radiation, herceptin for another 6 months resulted in NED.

    Mammogram 2012 showed atypical dysplasia in right breast. Ended up with bilateral mastectomy and DIEP flap reconstruction.

    After a relatively good period of time not being scared and worried of recurrence new symptoms have developed that has brought on a full-out obsessive concern of recurrence.

    Currently have enlarged lymph nodes of neck on left side, gripping breath-taking episodes that last several seconds nearly daily on ribs extending under left breast, left eardrum popping, pain on the top of my head on the left side, periods of dizziness and some occasional confusion. Blood tests look good except for slightly elevated platelets and trace blood in urine. Scheduled for PET scan next Wednesday. I am concerned about brain Mets along with these other symptoms.

    Anyone else out there with similar symptoms?

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    "Approximately 40 percent of all women with HER2-positive breast cancer will develop brain metastases."

    Seriously? Wow. That's ... sobering

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited March 2017

    Actually I don't believe that number. The original post was from 2015 and lots of things have changed in the HER2 scene. I have answered Wyattsmom and a new thread she started earlier this week.

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  • chocomousse
    chocomousse Member Posts: 157
    edited March 2017

    @TizzyLish, that's what stood out when I read it. I wasn't aware of that stat which is terrifying.

    It's crazy how some cancers behave like pathogens, stealthily evading detection by the immune system and constantly mutating. I know several cancers are linked to viral infections...I think certain types of breast cancer are too.

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  • hodges
    hodges Member Posts: 17
    edited March 2017

    I am not sure how rare we are, but I am with you sister.

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  • chocomousse
    chocomousse Member Posts: 157
    edited March 2017

    @MinusTwo, this study was published in 2017.

    https://link.springer.com/article/10.1007/s10585-017-9839-9

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    What I've read says that patients with Her2+ metastatic disease have a risk of brain metastasis that ranges from 25 to 40 percent. Still alarming, of course, but slightly less so than 40 percent of all women with Her2+ breast cancer.

    Which is true? Hard to say. There's so much conflicting information out there. For me personally, fixating on stats sends me very quickly into a downward spiral of fear and it's very difficult to climb back out.

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  • Nan812
    Nan812 Member Posts: 289
    edited March 2017

    hello everyone....i need help understanding something... when i see HER2-positive, i read it as HER2 negative positive. I'm very confused by this...can anyone explain...is that a dash or a negative sign??

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  • cross_fingers
    cross_fingers Member Posts: 4
    edited March 2017

    I agree with TizzyLish -- I think the cited article is incorrectly stating that 40% of Her-2 positive breast cancer patients develop brain mets. Stats I've seen state that 25-50% of persons with metastatic Her-2 disease go on to develop brain mets. Certainly much different.

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  • Kattis894
    Kattis894 Member Posts: 218
    edited March 2017

    Hmm...this surprises and concerns me deeply...thought my chances were in the 80% for a 5 year survival according to my onc..so this seems very strange to me I must say...is this true?

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  • Kimm992
    Kimm992 Member Posts: 135
    edited March 2017

    I agree that the 40% stat has to be incorrect...that just simple can't be true. It would make more sense that 40% of people with mets go on to have brain mets.

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  • mistyeyes
    mistyeyes Member Posts: 584
    edited March 2017

    If I have HER2+ does that mean it will be metastastic?



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  • Kimm992
    Kimm992 Member Posts: 135
    edited March 2017

    mistyeyes....NO it's does NOT!

    Most people do just fine.

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  • LoriKnous
    LoriKnous Member Posts: 80
    edited May 2017

    This is very interesting...... I am er/pr- and Her2+, 10 years since my first diagnosis, and now 5 years since my mets diagnosis. Knowing only a hand full of women with Her2, and only 3 others that are er/pr- Her2+ like myself, it does get a little scary. One of these women have passed and 2 have had brain lesions that were radiated with gamma knife. Thankfully they are doing well right now. I do have a brain MRI next week, so only positive thoughts on this roller coaster ride.

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  • freeofbreastcancer
    freeofbreastcancer Member Posts: 5
    edited September 2017

    This not a reply...could not get a new message going.

    What causes tumor markers to jump around and go higher than is normal but no return of cancer is found.

    My breast marker usually in the 40s. Normal range 20 and 30s. It started out after surgery in the 20s.

    My pancretic has been in the 20's since 2014 and in Sept. 2017 it was 34. Up to 35 is normal. I hope if it jumps higher everything is ok. They say they don't worry until it hits the 50s.


    I just don't understand why they rise and nothing is wrong. I am glad nothing is wrong but just don't understand.

    Any thoughts?

    RB

    9/2017

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  • Drained6513
    Drained6513 Member Posts: 82
    edited September 2017

    Ok, my oncologist pretty much said once I am finished my Herceptin in December, my risk of any recurrence anywhere is extremely low. I had a left mastectomy, mine was mainly DCIS with some focal invasion. 7 mm was the largest, but Pagets as well. The DCIS was so large, there wasn't really any sense in trying to have just a lumpectomy. I felt with the pagets too, it was just best to take it all, the whole breast. I just didn't want to take any chance of any being missed. So LoriKnous, you had no lymphnode invasion in yours first diagnosis, ten years ago? I am surprised it spread.. I am also very sorry for you that it did. You sound so strong on here. Did you have a lumpectomy or mastectomy on your first diagnosis? I don't know if that makes a difference?

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  • Wiegp22
    Wiegp22 Member Posts: 268
    edited October 2017

    same as you and will also have a Brian MRI next week


    Paul

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