Triple-Negative Invasive Breast Carcinoma: Incidence and Clinical - Pathological Characteristics
DOI:
https://doi.org/10.51481/amc.v52i2.641Keywords:
breast cancer, triple-negative, immunohistochemistry, progesterone and estrogen receptors, HER-2Abstract
Aim: The epidemiological behavior of malignant tumors in our country has undergone an important change during the last years, Breast carcinoma has increased its incidence, occupying the second place in malignancies in women and the first one in mortality. This type of tumor has characteristic features from the immunohistochemistry, standpoint since they can express different receptors such as estrogens, progesterone and HER2 or receptor 2 of epidermal human growth factor. It is known that carcinomas that do not express any of these 3 receptors have worse prognosis. Our objective is to define the main characteristics of the so called triple negative tumors and determine their rol within the total group of breast carcinomas.
Methodology: All cases of breast cancer seen at the Pathology Department of the Hospital San Juan de Dios, from January 1 to December 31, of 2006 were included if they had immunohistochemistry studies. The age of the patient;s, and the histological type and degree of differentiation of each one of the tumors was recorded. The triple negative group was separated and an statistical analyses was undertaken utilizing the Epi Info 3.3.4 program.
Results: Of 221 patients diagnosed with breast carcinomas, 40 patients were identified as triplenegative cancer, giving an incidence of 18% (I.C. 95%, 12,79 - 23,40), they had an average age of 54 years (I.C. 95%, 50 - 58 ) with a median of 52 and mode of 48. Likewise, triple-negative cancer individuals were more related with ductal infiltratiing: 67,5% (I.C. 95%, 51,73-83,26), followed by unfiltrating lobular:12,5% (I.C.95%, 4,18 - 26,80), medular, 5 % and with other such as papillary Regarding the degree of differentiation, 23 cases were III degree, 8 were II degree , and 3 were I degree.
Conclusion: Triple-negative breast cancers affect young women, are of higher histological grade, have larger tumor size and have a more aggressive clinical behavior, and preferentially they are of infiltrating ductal histological type. The incidence in our study seems to be higher than the one reported in the world literature. Due to the fact that this was based only on determination of receptors, other tests might be necessary such as CK5/6 and 17 stains to verify the cases. In addition, in this study a high proportion of tumors were of lobular type, other tests might be indicated such as e-cadherin to verify the cases of lobular carcinomas to increase in this way the reliability of results.
Downloads
References
Ministerio de Salud Pública. Incidencia de tumores malignos más frecuentes en mujeres en Costa Rica 1995-2006. Unidad de Estadística, Registro Nacional de Tumores. 2008
Rosen P. Patología mamaria de Rosen. Seg. ed. Venezuela: Editorial AMOLCA. 2005.
Sørlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci. 2001; 98:10869-10874.
Hayes DF, Thor AD. c-erbB-2 in breast cancer: development of a clinically useful marker. Semin Oncol. 2002; 29: 231-245.
Alejandro C. Gene expression profiles for therapeutic decisions in breast cancer. Rev. méd Chile. 2007; 135: 257-263.
Mocellin S, Provenzano M, Rossi CR, Pilati P, Nitti D, Lise M. DNA array-based gene profiling: from surgical specimen to the molecular portrait of cancer. Ann Surg. 2005; 241: 16-26.
van't Veer L, Dai H, van de Vijver M, He Y, Hart A, Mao M et al. Gene expression profiling predicts clinical outcome of breast cancer. Nature.
; 415: 530-536.
Cleator S, Heller W, Coombes C. Triple negative breast cancer: therapeutic options. Lancet Oncol. 2007; 8: 235-244.
Bauer K, Brown M, Cress R, Parise C, Caggiano V. Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative and HER2-negative invasive breast cancer, the socalled triple-negative phenotype. Cancer. 2007; 109: 1721-1729.
Nelson HD, Fuman LH, Fu R, Harris EL. Genetic risk assessment and BRCA Mutation testing for breast and ovarian cancer susceptibility: systematic evidence review for the U.S. preventive services task force. Ann Intern Med. 2005; 143:362-379.
Análisis Epidemiológico de Datos Tabulados (EPIDAT): Organización Mundial de la Salud, Organización Panamericana de la Salud. En: http://www.paho.org/Spanish/SHA/epidat.htm
Jiménez G, Villalobos M, Jiménez E, Palma W. Determinación de la efectividad de cinco protocolos de extracción de ADN a partir de material parafinado para estudios moleculares. Rev med UCR. 2007; 1: 10-19.
Rakha E.A. Morphology and immunophenotypic analysis of breast carcinoma with basal and myoepithelial differentiation. J Pathology. 2006; 208: 495-506.
Mi -Jung Kim, Jae Y. Ro, Sei-Hyun Ahn, Hak Hee Kim, Sung Bae Kim, Gyungyub Gong. Clinicopathologic significance of the basallike subtype of breast cancer: a comparison with hormone receptor and Her2/neu-overexpressing phenotypes. Human Pathology. 2006; 37: 1217-1226.
Spitale A, Mazzola P, Soldini D, Mazzuccheli L, Bordoni A. Breast cancer classification according to immunohistochemical markers: clinicopathologic features and short-term survival analysis in a population-based study from the South of Switzerland. Ann Oncol.
: 1-8.
Downloads
Published
Issue
Section
License
Copyright (c) 2010 Acta Médica Costarricense
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)
