INVASIVE TRIPLE NEGATIVE BREAST CANCER WITH BASAL AND NON-BASAL-LIKE IMMUNOPHENOTYPES
PROGNOSTIC IMPLICATIONS
Keywords:
Triple negative breast neoplasms, breast, breast neoplasmsAbstract
factors in patients being treated for triple negative type of breast cancer in the Barão Lucena Hospital, Recife, Pernambuco. Method: The study was conducted with 125 female patients suffering from triple negative breast cancer who underwent surgical treatment in the mastology service of Barão Lucena Hospital from 2009 to 2012. The clinical and pathological features of the tumors were studied and correlated with basal and non-basal subtypes. A descriptive data analysis was carried out using tables and/or graphs for qualitative variables. Association analysis was performed using χ2 test for independence. In tables that showed expected frequency lower than 5, in more than 20% of cells, we used the Fisher’s exact test. In addition, the odds ratio (OR) and the confidence interval (CI) for OR were calculated. In the entire analysis, a 5% significance level was considered. Results: Mean age was 49 years; regarding race, black was present in 83 (66.4%). The most common histological type was ductal, in 111 (88.8%). The pathological stage I/II was the most common, in 87 (69.6%) patients. A total of 71 patients (56.8%) showed no axillary metastasis. Regarding the type of surgery, the conservative one was performed in 57 (45.6%), including sectorectomy and oncoplastic surgery. The recurrence was present in 30 patients, basal in 16 (53.3%) patients and 14 (46.7%) in the non-basal, and bone metastasis was the most frequent. Conclusion: In this triple-negative tumor sample, the most important facts related to survival were: being aged less than 40 years, histological type, cytokeratin CK5/6 and higher significance level of the factors EGFR and KI-67.
Downloads
References
Tavassoli FA. Normal development and anomalies of the breast. In: Pathology of the Breast; 2003. p. 45.
American Cancer Society. Leading sites of new cancer cases and deaths-2007 estimates [Internet]. 2007 [cited 2017 nov 22]. Available from: https://www.cancer.org/content/dam/cancerorg/research/cancer-facts-and-statistics/annual-cancerfacts-and-figures/2017/leading-sites-of-new-cancer-casesand-deaths-2017-estimates.pdf
Page DL, Dupont WD. Anatomic markers of human premalignancy and risk of breast cancer. Cancer. 1990;66(Suppl 6):1326-35.
van’t Veer LJ, Dai H, van de Vijver MJ, He YD, Hart AA, Mao M, et al. Gene expression profiling predicts clinical outcome of breast cancer. Nature. 2002;415(6871):530-6. DOI: 10.1038/415530a
Page DL, Jensen RA, Simpson JF. Routinely available indicators of prognosis in breast cancer. Breast Cancer Res Treat. 1998;51(3):195-208.
Lakhani SR, Ellis, IO, Schnitt SJ, Tan PH, van de Vijver MJ. WHO classification of tumors of the breast. Lyon: IARC Press; 2012.
Reis-Filho JS, Westbury C, Pierga JY. The impact of expression profiling on prognostic and predictive testing in breast cancer. J Clin Pathol. 2006;59(3):225-31. DOI: 10.1136/jcp.2005.028324
Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, et al. America society of clinical oncology/college of america pathologists guideline recommendations for human epidermial growth factor receptor 2 testing in breast cancer. Arch Pathol Lab Med. 2007;131(1):18-43. DOI: 10.1043/1543-2165(2007)131[18:ASOCCO]2.0.CO;2
Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, et al. American society of clinical oncology/ college of american pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. Arch Pathol Lab Med. 2010;134(7):e48-72. DOI: 10.1043/1543-2165-134.7.e48
American College of Radiology. Mammography. In: Illustrated breast imaging reporting and data system (BI-RADS). 4th ed. Reston: American College of Radiology; 2003.
Pascalicchio JC, Fristachi CE, Baracat FF. Câncer da mama: fatores de risco, prognósticos e preditivos. Rev Bras Mastol. 2001;11:71-84.
Colleoni M, Rotmensz N, Peruzzotti G, Maisonneuve P, Orlando L, Ghisini R, et al. Role of endocrine responsiveness and adjuvant therapy in very young women (bellow 35 year) with operable breast cancer and node negative disease. Ann Oncol. 2006;17(10):1497-503. DOI: 10.1093/annonc/mdl145
Goldhirsch A, Ingle JN, Gelber RD, Coates AS, Thürlimann B, Senn HJ. Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009. Ann Oncol. 2009;20(8):1319-29. DOI: 10.1093/annonc/mdp322
Sales RA, Mcguire WL, Clark GM. Prognostic factors in breast cancer. Semin Surg Oncol. 1989;5(2):102-10.
Albain KS, Allred DC, Clark GM. Breast cancer outcome and predictors of outcome: are there age differentials? J Natl Cancer Inst Monogr. 1994;(16):35-42.
van Belle V, van Calster B, Brouckaert O, Bempt IV, Pintens S, Harvey V, et al. Qualitative assessment of the progesterone receptor and HER-2 improves the nottingham prognostic index up to 5 years after breast cancer diagnosis. J Clin Oncol. 2010;28(27):4129-34. DOI: 10.1200/JCO.2009.26.4200
Nixon AJ, Neuberg D, Hayes DF, Gelman R, Connolly JL, Schnitt S, et al. Relationship of patient age to pathologic features of the tumor and prognosis for patients with stage I or II breast cancer. J Clin Oncol. 1994;12(5);888-94. DOI: 10.1200/JCO.1994.12.5.888
Colonna M, Delafosse P, Uhry Z, Poncet F, Arveux P, Molinie F, et al. Is breast cancer incidence increasing among young women? An analysis of the trend in France for the period 1983-2002. Breast 2008;17(3):289-92. DOI: 10.1016/j.breast.2007.10.017
Sidoni A, Cavaliere A, Bellezza G, Scheibel M, Bucciarelli E. Breast cancer in young women: clinicopathological features and biological specificity. Breast. 2003;12(4):247-50.
Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL. Human breast cancer: correlation of relapse and survival with amplification of the Her-2/neu oncogene. Science. 1987;235(4785):177-82.
Dati C, Muraca R, Tazartes O, Antoniotti S, Perroteau I, Giai M, et al. C-erbB-2 and ras expression levels in breast cancer are correlated and show a co-operative association with unfavorable clinical outcome. Int J Cancer. 1991;47(6):833-8.
Clark GM. Interpreting and integrating risk factors for patients with primary breast cancer. J Natl Cancer Inst Monogr. 2001:17-21.
Farzadnia M, Meibodi NT, Shandiz Fh, Mahmoudi M, Bahar M, Memar B, et al. Evaluation of HER2/neu oncoprotein in serum and tissue samples of women with breast cancer: correlation with clinicopathological parameters. Breast. 2010;19(6):489-92. DOI: 10.1016/j.breast.2010.05.012
Newman LA, Mason J, Cote D, Vin.Y, Carolin K, Bouwman D, Colditz GA. African-American ethnicity, socioeconomic status, and breast cancer survival: a meta-analysis of 14 studies involving over 10,000 African-American and 40,000 White American patients with carcinoma of the breast. Cancer. 2002;94(11):2844-54. DOI: 10.1002/cncr.10575
Elledge RM, Clark GM, Chamness GC, Osborne CK. Tumor biologic factors and breast cancer prognosis among white, Hispanic, and black women in the United States. J Natl Cancer Inst. 1994;86(9):705-12
Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K,. Race, breast cancer subtypes, and survival in the Carolina breast cancer study. JAMA. 2006;295(21):2492-502. DOI: 10.1001/jama.295.21.2492
Lund MJ, Trivers KF, Porter PL, Coates RJ, Leyland-Jones B, Brawley OW, et al. Race and triple negative threats to breast cancer survival: a population-based study in Atlanta, GA. Breast Cancer Res Treat. 2009;113(2):357-70. DOI: 10.1007/s10549-008-9926-3
Carvalho FM, Bacchi LM, Pincerato KM, Van de Rijn M, Bacchi CE. Geographic differences in the distribution of molecular subtypes of breast cancer in Brazil. BMC Womens Health. 2014;14:102. DOI: 10.1186/1472-6874-14-102
Tavassoli FA, Devilee P. Pathology and genetics of tumors of the breast and female genital organs. Lyon: WHO/IARC; 2003.
Simpson JF, Page DL. Prognostic value of histopathology in the breast. Semin Oncol. 1992;19(3):254-62.
Diab SG, Clark GM, Osborne CK, Libby A, Allred DC, Elledge RM. Tumor characteristics and clinical outcome of tubular and mucinous breast carcinomas. J Clin Oncol. 1999;17(5):1442-8. DOI: 10.1200/JCO.1999.17.5.1442
Arpino G, Bardou VJ, Clark GM, Elledge RM. Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res. 2004;6(3):r149-56. DOI: 10.1186/bcr767
Tot T. The diffuse type of invasive lobular carcinoma of the breast: morphology and prognosis. Virchows Arch. 2003;443(6):718-24. DOI: 10.1007/s00428-003-0881-4
Carter CL, Allen C, Henson DE. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer. 1989;63(1):181-7.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Darley de Lima Ferreira Filho, Nancy Cristina Ferraz de Lucena Ferreira, Maria do Carmo Abreu e Lima, Alvaro Antonio Bandeira Ferraz, Danyelly Bruneska Gondim Martins, Thais de Lucena Ferreira
This work is licensed under a Creative Commons Attribution 4.0 International License.
