Patterns of Skin and Soft Tissue Metastases from Breast Cancer according to Subtypes: Relationship between EGFR Overexpression and Skin Manifestations

Abstract

Objectives: We evaluated whether skin changes and soft tissue infiltration patterns reflect breast cancer subtypes based on the breast hormonal receptor (HR) and human epidermal growth factor receptor 2 (HER2) status at the time of skin metastasis. Methods: We retrospectively reviewed the patients' medical records with radiologic imaging studies. Results: The numbers of patients of each subtype were as follows: HR positive (HR+ve) 53 (42.4%), HER2 enriched 43 (34.4%), and triple negative (TN) 29 (23.2%). The presence of skin ulceration was found more commonly in the HR+ve group than in the others (57.1% for HR+ve vs. 25% for HER2 enriched vs. 15.4% for TN, p = 0.019). Erythematous infiltrations were shown predominantly in the TN group (19.0 vs. 54.2 vs. 84.6%, respectively, p < 0.000). On CT scans, soft tissue infiltration appeared to be more common in the HER2-enriched and TN groups than in the HR+ve group (24.5 vs. 41.9 vs. 48.3%, respectively, p = 0.013). Erythematous infiltrative lesions were more common in patients with epidermal growth factor receptor overexpression (p = 0.036). Conclusion: The patterns of skin involvement including surrounding soft tissue infiltration may reflect breast cancer subtype. Prospective evaluation is necessary to confirm their influential effect on breast cancer subtypes. Copyright (C) 2011 S. Karger AG, Basel