Clinicopathological analyses of triple negative breast cancer using surveillance data from the Registration Committee of the Japanese Breast Cancer Society
Member of the Research Group, Japanese Breast Cancer Society, Tokyo, Japan. Breast Cancer
(Impact Factor: 1.59).
06/2009; 17(2):118-24. DOI: 10.1007/s12282-009-0113-0
Triple negative (TN) breast cancer is defined as a subtype that is negative for estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2). To clarify the characteristics of TN breast cancer, surveillance data of the Registration Committee of the Japanese Breast Cancer Society were analyzed.
Of 14,748 cases registered in 2004, 11,705 (79.4%) were examined for ER, PgR, and HER2. Of these, the most prevalent (53.8%) was a hormone-responsive subtype with ER positive/PgR positive/HER2 negative, followed by TN subtype (15.5%).
The proportion of postmenopausal patients was relatively high in the TN subtype. This cancer was diagnosed at a slightly advanced stage and with more cases positive for lymph node metastases than other subtypes. Morphologically, the TN subtype was more frequently classified as solid-tubular carcinoma. Mucinous, tubular, or secretary carcinomas were frequently found in the hormone receptor positive/HER2 negative subtype, while squamous cell carcinoma, spindle cell carcinoma, and metaplastic carcinoma with bone/cartilage metaplasia were very frequently found in the TN group. Apocrine carcinoma was also found very frequently in the TN group. Selection of chemotherapy was not based on receptor subtypes, but was determined by the degree of tumor progression.
Although TN types are similar to basal-like breast tumor, as determined by gene profiling, their diagnosis needs verification by determination of the level of epidermal growth factor receptor or cytokeratin 5/6 expression. TN type should be examined further for immunohistochemical features and analyzed for prognostic details in this cohort.
Available from: Semir Vranic
- "In situ and invasive carcinomas Similar prognosis D'Amore et al. (1988) 34 Invasive carcinoma Similar prognosis Aoyagi et al. (1990) 10 Invasive carcinomas Better prognosis Abati et al. (1990) 72 Both in situ and invasive carcinoma Similar prognosis Gilles et al. (1994) 17 Invasive carcinomas Not given Matsuo et al. (1998)* 12 In situ and invasive carcinomas* Invasive carcinoma do worse Takeuchi et al. (2004) 33 Invasive carcinomas Similar prognosis Japaze et al. (2005) 37 PAC Better prognosis Tanaka et al. (2008) 57 Invasive carcinomas Similar prognosis Iwase et al. (2010) "
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ABSTRACT: Apocrine carcinoma of the breast is a rare, special type of breast carcinoma showing distinct morphologic, immunohistochemical and molecular genetic features. Apocrine epithelium has a characteristic steroid receptor profile that is estrogen receptor and progesterone receptor negative and androgen receptor positive. This combination of morphologic and immunohistochemical characteristics is essential for the proper recognition of the apocrine carcinomas. Strictly defined, apocrine carcinomas express either Her-2/neu or EGFR, which along with androgen receptor positivity make patients with the apocrine carcinoma eligible for targeted therapies.
Available from: Hiroko Tsunoda
- "At present, chemotherapy is the only option to treat this type of cancer. This subtype is found in approximately 15.5% of all breast cancer cases in Japan (Iwase et al., 2010). The percentage of other subtypes are as follows; Luminal A (hormone receptors positive and HER2 negative), 69.0%; Luminal B (hormone receptors positive and HER2 positive), 7.3% and HER2-enriched (hormone receptor negative and HER2 positive), 8.2%. "
Available from: Benita Tan
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ABSTRACT: Triple-negative breast cancer, defined as that with negative expression of estrogen and progesterone receptors and cerbB2, accounted for 11% of invasive breast cancers in our study, drawn from an original cohort of 7048 women diagnosed with breast cancer from the files of the Department of Pathology, Singapore General Hospital, over 14 years. Women with triple-negative breast cancer were generally postmenopausal, with adverse pathological characteristics of high histological grade and frequent nodal metastases. Using a set of 61 invasive breast cancers earlier profiled into molecular subtypes with expression arrays, we defined specificity and sensitivity values for different immunohistochemical panels of basal keratins (CK5/6, CK14, CK17, 34 beta E12), CD117, EGFR, p63 and SMA in defining basal-like breast cancer. Subsequent application of a tri-panel of CK14, EGFR and 34 beta E12 (specificity 100% and sensitivity 78%) to our group of 653 triple-negative breast cancers delineated 84% to be basal-like. Immunohistochemical expression of individual biological markers correlated with unfavorable pathological parameters. We conclude that triple-negative breast cancers in an Asian population harbor adverse pathobiological features, and an immunohistochemical surrogate panel can be reliably used to define basal-like cancers among them.
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