Triple negative breast cancer – prognostically highly unfavourable group cancer of breast
Authors:
L. Minář 1
; M. Hvizdová 1; V. Weinberger 1
; E. Jandáková 2
Authors place of work:
Gynekologicko-porodnická klinika LF MU a FN Brno, přednosta prof. MUDr. P. Ventruba, DrSc.
1; Ústav patologie LF MU a FN Brno, přednosta doc. MUDr. J. Feit, CSc.
2
Published in the journal:
Ceska Gynekol 2012; 77(2): 132-138
Category:
Původní práce
Summary
Objective:
Presentation of the file prognostically highly unfavourable group cancers of breast.
Design:
Retrospective analysis.
Setting:
Department of Gynaecology and Obstetrics, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno.
Methods:
In the study, we retrospectively analyzed 47 patients with triple negative breast cancer, who have undergone in the period 2005–2008 complete treatment and then follow-up in Department of Gynaecology and Obstetrics, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno. 2/3 patients underwent primary surgery followed by adjuvant therapy, 1/3 patients underwent neoadjuvant chemotherapy followed by surgery and eventually adjuvant therapy. Then patients were transferred to follow-up.
Results:
Approximatelly 2/3 patients were diagnosed in early stages I and IIA FIGO, other patients in advanced stages, even though almost 90% of women participated regularly in mammography screening. With neoadjuvant chemotherapy was achieved complete pathological remission in 15% patients, in 70% patients reduction volume of the tumor at least 50%, other patients were resistant to chemotherapy. Recurrence of disease was detected by almost 39% of patients on condition follow-up at least 30 months after completion of primary treatment. Patients, who were diagnosed and treated in early stages, suffered more frequently from local recurrence and interval of recurrence from completion of primary treatment was longer. Patients, who were diagnosed and treated in advanced stages, suffered more frequently from remote metastasis and interval of recurrence from completion primary treatment was shorter.
Conclusion:
Triple negative cancers of breast are highly aggressive tumors with poor prognosis. They often are associated with lymphadenopathy and characterized by frequent occurrence of local recurrences and high risk of remote metastases. These tumors represent a large part of so-called interval cancers. Tumors often occurs in young women with BRCA1 mutations. Elementary systemic treatment is chemotherapy. Together continues the effort of highly targeted therapy, based on new findings in genomics and proteomics and on detection of many markers expressed by this version of breast cancer.
Key words:
triple negative cancer of breast, surgical treatment, neoadjuvant chemotherapy, lymphadenopathy, remote metastasis, recurrence.
Zdroje
1. Carey, LA., Dees, EC., Sawyer, L., et al. The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res, 2007, 13, p. 2329–2334.
2. Carey, LA., Perou, CM., Livasy, CA., et al. Race, breast cancer subtypes and survival in the Carolina Breast Cancer Study. JAMA, 2006, 295, p. 2492–2502.
3. Colleoni, M., Cole, BF., Viale, G., et al. Classical cyclophosphamide, methotrexate and fluorouracil chemotherapy is more effective in triple-negative, node-negative breast cancer: results from two randomized trials of adjuvant chemoendocrine therapy for node negative breast cancer. J Clin Oncol, 2010, 28(18), p. 2966–2973.
4. Collett, K., Stefansson, IM., Eide, J., et al. A basal epithelial phenotype is more frequent in interval breast cancers compared with screen detected tumors. Cancer Epidemiol Biomarkers Prev, 2005, 14, p. 1108–1112.
5. Fulford, LG., Reis-Filho, JS., Ryder, K., et al. Basal-like grade III invasive ductal carcinoma of the breast: patterns of metastasis and long-term survival. Breast Cancer Res 2007, 9:R4.
6. Glinsky, GV., Higashiyama, T., Glinskii, AB. Classification of human breast cancer using gene expression profiling as a component of the survival predictor algorithm. Clin Cancer Res, 2004, 10, p. 2272–2283.
7. Haffty, BG., Yang, Q., Weiss, M., et al. Locoregional relapse and distanc metastases in conservatively manager triple negative early – stage breast cancer. J Clin Oncol, 2006, 24, p. 5652–5657.
8. Juany, HJ., Neven, P., Drijkoningen, M., et al. Association between tumour characteristics and HER-2/neu by immunohistochemistry in 1362 women with primary operable breast cancer. J Clin Pathol, 2005, 58, p. 611–616.
9. Cho, EY., Choi, YL., Han, JJ., et al. Expression and amplification of Her2, EGFR and cyclin D1 in breast cancer: immunohistochemistry and chromogenic in situ hybridization. Pathol Int, 2008, 58, p. 17–25.
10. Isakoff, SJ. Triple-negative breast cancer: role of specific chemotherapy agents. [Review] Cancer J, 2010, 16(1), p. 53–61.
11. Jacquemier, J., Ginestier, C., Rougemont, J., et al. Protein expression profiling identifies subclasses of breast cancer and predicts prognosis. Cancer Res, 2005, 65, p. 767–779.
12. Kaplan, HG., Malmgren, JA. Impact of triple negative phenotype on breast cancer prognosis. Breast J. 2008. [Epub ahead of print].
13. Kusinska, R., Potemski, P., Jesionek-Kupnicka, D., et al. Immunohistochemical identification of basal-type cytokeratins in invasive ductal breast carcinoma-relation with grade, stage, estrogen receptor and HER2. Pol J Pathol, 2005, 56, p. 10710.
14. Lakhani, SR., Reis-Filho, JS., Fulford, L., et al. Prediction of BRCA1 status in patients with breast cancer using estrogen receptor and basal phenotype. Clin Cancer Res, 2005, 11, p. 5175–5180.
15. Liu, H., Fan, Q., Zhang, Z., et al. Basal-HER2 phenotype shows poorer survival than basal-like phenotype in hormone receptor-negative invasive breast cancers. Hum Pathol, 2008, 39, p. 167–174.
16. Livasy, CA., Karaca, G., Nanda, R., et al. Phenotypic evaluation of the basal-like subtype of invasive breast carcinoma. Mod Pathol, 2006, 19, p. 264–271.
17. Nahleh, Z. Neoadjuvant chemotherapy for triple-negative breast cancer: a review of current practice and future outlook. [Review] Med Oncol, 2010, 27(2), p. 531–539.
18. Národní onkologický registr České republiky, Ústav zdravotnických informací a statistiky ČR, data z let 1977–2008.
19. Rakha, EA., Putti, TC., Abd El-Rehim, DM., et al. Morphological and immunophenotypic analysis of breast carcinomas with basal and myoepithelial differentiation. J Pathol, 2006, 208, p. 495–506.
20. Ryška, A., Laco, J., Hornychová, H., et al. Nové trendy v diagnostice a klasifikaci karcinomu prsu. Čes Patol, 2009, 45(2), s. 29–34.
21. Schippinger, W., Dandachi, N., Regitnig, P., et al. The predictive value of EGFR and HER-2/neu in tumor tissue and serum for response to anthracycline-based neoadjuvant chemotherapy of breast cancer. Am J Clin Pathol, 2007, 128(4), p. 630–637.
22. Sorlie, T., Perou, CM., Tibshirani, R., et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA, 2001, 98, p. 10869–10874.
23. Sotiriou, C., Neo, SY., McShane, LM., et al. Breast cancer classification and prognosis based on gene expression profiles from a population–based study. Proc Natl Acad Sci USA, 2003, 100, p. 10393–10398.
24. Stark, A., Kapke, A., Schultz, D., et al. Advanced stages and poorly differentiated grade are associated with an increased risk of HER2/neu positive breast carcinoma only in white women: findings from a prospective cohort study of African-American and White-American women. Breast Cancer Res Treat, 2008, 107, p. 405–414.
25. Turashvili, G., Bouchal, J., Burkadze, G., et al. Differentiation of tumours of ductal and lobular origin: I. Proteomics of invasive ductal and lobular breast carcinomas. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2005, 149(1), p. 57–62.
26. Turashvili, G., Bouchal, J., Ehrmann, J., et al. Novel immunohistochemical markers for the differentiation of lobular and ductal invasive breast carcinomas. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2007, 151(1), p. 59–64.
27. van de Vijver, MJ., He, YD., van’t Veer, LJ., et al. A gene-expression signature as a predictor of survival in breast cancer. N Engl J Med, 2002, 347, p. 1999–2009.
28. Wang, Y., Klijn, JG., Zhang, Y., et al. Gene-expression profiles to predict distant metastasis of lymph-node-negative primary breast cancer. Lancet, 2005, 365, p. 671–679.
29. Wolff, AC., Hammond, ME., Schwarz, JN., et al. American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer. Arch Pathol Lab Med, 2007, 131, p. 18.
30. Yang, XR., Herman, ME., Simm, DL., et al. Differences in risk factors for breast cancer molecular subtypes in a population-based study. Cancer Epidemiol Biomarkers Prev. 2007, 16, p. 439-443.
Štítky
Detská gynekológia Gynekológia a pôrodníctvo Reprodukčná medicínaČlánok vyšiel v časopise
Česká gynekologie
![Číslo 2](https://www.prelekara.sk/media/cache/resolve/journal_issue/media/image_pdf/7a9c6c24cb265c06c3affaa87cbb4ba1.jpeg)
2012 Číslo 2
- Mýty a fakta ohledně doporučení v těhotenství
- Ne každé mimoděložní těhotenství musí končit salpingektomií
- Je „freeze-all“ pro všechny? Odborníci na fertilitu diskutovali na virtuálním summitu
- I „pouhé“ doporučení znamená velkou pomoc. Nasměrujte své pacienty pod křídla Dobrých andělů
Najčítanejšie v tomto čísle
- Triple negativní karcinom prsu – prognosticky vysoce závažná skupina mamárních malignit
- Možnosti IVF v nativním cyklu
- Uroinfekce v graviditě – kdy léčit, jak léčit a čím léčit
- Vedení porodu po předchozím císařském řezu, analýza výsledků z let 2007–2010