Overrepresentation of human epidermal growth factor receptor 2 positive- and Luminal B breast cancer metastases in the eyes and orbit

• Type of Material: Article
• Authors: Gustav Stalhammar, Karolinska Institutet; Hans E Grossniklaus, Emory University
• Language: English
• Date: 2022-12-14
• Publisher: SPRINGERNATURE
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41433-022-02363-1
• Title of Journal or Parent Work: EYE
• Volume: 37
• Issue: 12
• Start Page: 2499
• End Page: 2504
• Grant/Funding Information: This work was supported by the following grants to Dr. Stålhammar. The Swedish Cancer Society (200798 Fk). The Swedish Eye Foundation (2022-05-02). Karolinska Institutet (FS-2021-01131). Region Stockholm (20200356). Open access funding provided by Karolinska Institute.
• Keywords: Ophthalmology; DIGITAL IMAGE-ANALYSIS; FEATURES; INCISIONAL BIOPSIES; SUBCLASSES; EXPRESSION; IMPACT; PRIMARY THERAPY; MANAGEMENT; Life Sciences & Biomedicine; Science & Technology; TUMORS; INTERNATIONAL EXPERT CONSENSUS
• Research Categories: Health Sciences, Pathology; Biology, Neuroscience

Abstract

Background: Breast cancer is the most common cancer to spread to the choroid and orbit. Depending on a set of prognostic and predictive biomarkers, breast cancer can be divided into at least four distinct subtypes with separate treatment and clinical course. Subjects: Thirty-two patients with metastases to the eye and periocular area diagnosed between 2005 and 2020, of which 11 also had primary tumour tissue available. Expression levels of oestrogen- (ER) and progesterone receptors (PR), Human epidermal growth factor receptor 2 (HER2) and the proliferation marker Ki67 were analysed. Results: Twenty-five of 32 patients (78%) had a history of primary breast cancer, whereas the remaining 7 (22%) presented with metastatic disease. Of available metastases, 83% were positive for ER, 37% for PR, 54% for HER2, and 50% for Ki67. Metastases had significantly lower proportions of PR-positive cells than primary tumours, and the distribution of the Luminal A, Luminal B, HER2 enriched and triple-negative subtypes differed between primary tumours and metastases (P = 0.012): Six of 9 patients with a full set of biomarkers on both primary tumours and metastases switched subtype (67%), and 23 of 32 metastases (77%) were of the Luminal B subtype. Conclusions: Nearly 4 in 5 breast cancer metastases in the eyes and orbit are of the Luminal B subtype, and a majority are HER2 positive. The breast cancer subtype frequently switches between primary tumours and metastases. Future studies should evaluate these results in larger cohorts.