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Background: Brain metastases (BM) are frequently diagnosed in patients with HER-2-positive metastatic breast cancer; in addition, an increasing incidence was reported for triple-negative tumours. We aimed to compare brain metastases free survival (BMFS) of breast cancer subtypes in patients treated between 1996 until 2010. Methods: Brain metastases free survival was measured as the interval from diagnosis of extracranial breast cancer metastases until diagnosis of BM. HER-2 status was analysed by immunohistochemistry and reanalysed by fluorescent in situ hybridisation if a score of 2+ was gained. Oestrogen-receptor (ER) and progesterone-receptor (PgR) status was analysed by immunohistochemistry. Brain metastases free survival curves were estimated with the Kaplan–Meier method and compared with the log-rank test. Results: Data of 213 patients (46 luminal/124 HER-2/43 triple-negative subtype) with BM from breast cancer were available for the analysis. Brain metastases free survival differed significantly between breast cancer subtypes. Median BMFS in triple-negative tumours was 14 months (95% CI: 11.34–16.66) compared with 18 months (95% CI: 14.46–21.54) in HER-2-positive tumours (P=0.001) and 34 months (95% CI: 23.71–44.29) in luminal tumours (P=0.001), respectively. In HER-2-positive patients, co-positivity for ER and HER-2 prolonged BMFS (26 vs 15 m; P=0.033); in luminal tumours, co-expression of ER and PgR was not significantly associated with BMFS. Brain metastases free survival in patients with lung metastases was significantly shorter (17 vs 21 months; P=0.014). Conclusion: Brain metastases free survival in triple-negative breast cancer, as well as in HER-2-positive/ER-negative, is significantly shorter compared with HER-2/ER co-positive or luminal tumours, mirroring the aggressiveness of these breast cancer subtypes.

Aims In patients with early breast cancer sentinel node biopsy (SNB) proved to be an accurate procedure for axillary staging with significantly reduced morbidity. Medium- and long-term observational studies are needed to establish, whether SNB alone is able to prevent locoregional recurrence without impairing long-term survival. Methods 298 patients with invasive breast cancer were subjected to SNB in a prospective audit. Lymphatic mapping was performed with blue dye and radiocolloids. 180 patients had SNB alone (group 1), while 118 subsequently underwent axillary dissection (AD; group 2). In ten patients AD was omitted despite the tumor burden in the SN. Clinical follow-up studies were performed at regular intervals. The mean follow-up time was 47 months in group 1 (range 7–90) and 46 months in group two (range 1–87 months). Results Sentinel nodes were identified in 286 out of 298 patients (96%). One patient in group 1 developed axillary and simultaneous supraclavicular lymph node recurrence. After AD regional relapses have so far not been observed. One ipsilateral local recurrence was detected in each group. Five patients in group 1 and 15 patients in group 2 developed distant metastases. Three out of six and eight out of nine patients, respectively, died of their advanced disease. All patients with SN tumor infiltration not subjected to AD are alive and well. Conclusions Axillary recurrence is rare after sentinel node biopsy alone. Its rate is comparable to that after AD, even in patients with SN micrometastases. These conclusions are confirmed by reports in the literature.

The prognosis for patients suffering from malignant gliomas remains dismal. We report on 10 patients with recurring or progressing high-grade gliomas who were treated at our institution with Bevacizumab alone or in combination with cytostatic drugs over the last 2 years. The survival time from the start of the VEGFR antibody therapy on average was 18 weeks (10–30 weeks) and after Avastin was discontinued patients lived an average of 7 weeks (1–14 weeks). The above results support further studies of this very promising drug in the form of randomized studies of malignant glioma. In the primary therapy concept and in the case of recurrence the best combination Bevacizumab with cytostatics, radiation therapy or other targeted therapies have to be clarified.

This is a report on 14 patients receiving vindesine continuously for between 1 and 7 years. Total vindesine doses ranged from 86 mg to 454 mg and the longest treatment duration was 2564 days. Although there was no patient without a transient acute or subacute toxicity, no unequivocal signs of long-term toxicity have been observed so far. Greater caution must be given to the concomitant use of higher radiation doses and vindesine, since local reactions were more pronounced especially at the lung. The drug seems to be tolerated for longer periods without major or cumulative toxicity, which makes it suitable for use in the adjuvant setting, for instance, or within an antimetastatic approach.

1076 Background: Since the introduction of trastuzumab (T), different groups reported an increased incidence of brain metastases (BM) in patients (pts) with HER2-positive breast cancer (BC), although one centre published contradicting results. Usually, this is attributed to prolonged survival, in association with the inability of antibodies to pass the blood-brain-barrier. Furthermore, based on preclinical data, it was suggested that HER2-positive BC had an increased affinity to brain tissue. We investigated which factors were potentially associated with shorter time to development of BM. Methods: One hundred ninety-four pts with BM from BC were identified at two Austrian centres. All received whole brain radiotherapy (WBRT) of 30 Gy with or without boost irradiation or surgical resection. All pt data concerning epidemiology, histology, and outcome is available. A multivariate analysis (Cox regression) was performed to identify factors (age, grading, ER/PgR-status, HER2-status, tumour stage at diagnosis, ...

Carcinoma in the 'empty breast' in our experience is so common that we doubt Wolfe's conclusions in his classification of parenchymal patterns. Amongst patients over 60 years, almost 70% of carcinomas were situated in an 'empty' parenchyma and they did not develop in a parenchymal group above P1. Mammographically, the 'empty breast' is the structureless fatty breast of older women after the menopause. Some authors believe that there is a lower incidence of carcinomas in this type of breast than in other types of parenchyma, such as those showing mastopathies. Our experience concerning carcinomas in involuted breasts is described.