Triple-Negative Breast Cancer: Clinical Features and Patterns of Recurrence

Clinical Cancer Research - Tập 13 Số 15 - Trang 4429-4434 - 2007
Rebecca Dent1, Maureen Trudeau1, Kathleen I. Pritchard1, Wedad Hanna1, Harriet K. Kahn1, Carol Sawka1, Lavina Lickley1, Ellen Rawlinson2, Ping Sun2, Steven A. Narod2
11Department of Medical Oncology, Sunnybrook Health Sciences Center and University of Toronto;
22Women's College Research Institute, Women's College Hospital and University of Toronto, Toronto, Ontario, Canada

Tóm tắt

Abstract Purpose: To compare the clinical features, natural history, and outcomes for women with “triple-negative” breast cancer with women with other types of breast cancer. Experimental Design: We studied a cohort of 1,601 patients with breast cancer, diagnosed between January 1987 and December 1997 at Women's College Hospital in Toronto. Triple-negative breast cancers were defined as those that were estrogen receptor negative, progesterone receptor negative, and HER2neu negative. The prognostic significance of triple-negative breast cancer was explored. Results: The median follow-up time of the 1,601 women was 8.1 years. One hundred and eighty of 1,601 patients (11.2%) had triple-negative breast cancer. Compared with other women with breast cancer, those with triple-negative breast cancer had an increased likelihood of distant recurrence (hazard ratio, 2.6; 95% confidence interval, 2.0-3.5; P < 0.0001) and death (hazard ratio, 3.2; 95% confidence interval, 2.3-4.5; P < 0.001) within 5 years of diagnosis but not thereafter. The pattern of recurrence was also qualitatively different; among the triple-negative group, the risk of distant recurrence peaked at ∼3 years and declined rapidly thereafter. Among the “other” group, the recurrence risk seemed to be constant over the period of follow-up. Conclusions: Triple-negative breast cancers have a more aggressive clinical course than other forms of breast cancer, but the adverse effect is transient.

Từ khóa


Tài liệu tham khảo

Perou CM, Sorlie T, Eisen MB, et al. Molecular portraits of human breast tumours. Nature 2000;406:747–52.

Sorlie T, Perou CM, Tibshirani R, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci U S A 2001;98:10869–74.

Sorlie T, Tibshirani R, Parker J, et al. Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci U S A 2003;100:8418–23.

Carey LA, Perou CM, Livasy CA, et al. Race, breast cancer subtypes and survival in the Carolina Breast Cancer Study. JAMA 2006;295:2492–502.

Lakhani SR, Van De Vijver MJ, Jacquemier J, et al. The pathology of familial breast cancer: predictive value of immunohistochemical markers estrogen receptor, progesterone receptor, HER-2, and p53 in patients with BRCA1 and BRCA2. J Clin Oncol 2002;20:2310–8.

Foulkes WD, Steffansson IM, Chappuis PO, et al. Germline BRCA1 mutations and a basal epithelial phenotype in breast cancer. J Natl Cancer Inst 2003;95:1482–5.

Minn AJ, Gupta GP, Siegel PM, et al. Genes that mediate breast cancer metastasis to lung. Nature 2005;436:518–24.

Rodriguez-Pinilla SM, Sarrio D, Honrado E, et al. Prognostic significance of basal-like phenotype and fascin expression in node-negative invasive breast carcinomas. Clin Cancer Res 2006;12:1533–9.

Banerjee S, Reis-Filho JS, Ashley S, et al. Basal-like breast carcinomas: clinical outcome and response to chemotherapy. J Clin Pathol 2006;59:729–35.

Sawka CA, Pritchard KI, Lickley HLA, et al. The Henrietta Banting Breast Centre database: a model for clinical research utilizing a hospital-based inception cohort. J Clin Epidemiol 1995;48:779–86.

Foulkes WD, Bruder JS, Stefansson JM, et al. The prognostic implication of the basal-like (cycle E high/p27low/p53+/glomeruloid-microvascular proliferation+) phenotype of BRCA1-related breast cancer. Cancer Res 2004;64:830–5.

Foulkes WD, Metcalfe K, Hanna W, et al. Disruption of the expected positive correlation between breast tumor size and lymph node status in BRCA-1 related breast carcinoma. Cancer 2003;98:1569–77.

Collett K, Stefansonn 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;14:1108–12.

Nielsen TO, Hsu FD, Jensen K, et al. Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast cancer. Clin Cancer Res 2004;10:5367–74.

van de Rijn M, Perou CM, Tibshirani R, et al. Expression of cytokeratins 17 and 5 identifies a group of breast carcinomas with poor clinical outcome. Am J Pathol 2002;161:1991–6.

Abd El-Rehim DM, Pinder SE, Paish CE, et al. Expression of luminal and basal cytokeratins in human breast carcinoma. J Pathol 2004;203:661–71.

Carey LA, Dees EC, Sawyer LR, et al. The triple negative paradox: primary tumor chemosensitivity of the basal-like breast cancer phenotype. Breast Cancer Res Treat 2004;80:1023.

Jones C, Ford E, Gillett C, et al. Molecular cytogenetic identification of subgroups of grade III invasive ductal breast carcinomas with different clinical outcomes. Clin Cancer Res 2004;10:5988–97.

Abd El-Rehim DM, Ball G, Pinder SE, et al. High-throughput protein expression analysis using tissue microarray technology of a large well-characterised series identifies biologically distinct classes of breast cancer confirming recent cDNA expression analyses. Int J Cancer 2005;116:340–50.

Siziopikou KP, Cobleigh M. The basal subtype of breast carcinomas may represent the group of breast tumours that could benefit from EGFR-targeted therapies. Breast 2007;16:104–7.

Narod SA, Foulkes WD. BRCA1 and BRCA2: 1994 and beyond. Nat Rev Cancer 2004;4:665–76.

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;11:5175–80.

Ratanaphan A, Canyuk B, Wasiksiri S, Mahasawat P. In vitro platination of human breast cancer suppressor gene 1 (BRCA1) by the anticancer drug carboplatin. Biochim Biophys Acta 2005;1725:145–51.

Thông tin
Thông tin xuất bản

Clinical Cancer Research

Tập 13 Số 15

4429-4434

Thông tin tác giả