Clinicopathological features and prognosis of triple-negative breast cancer: a comparison between younger (&lt;60) and elderly (≥60) patients

Qiu, Jiaojiao; Xue, Xinying; Li, R.; Wang, Jiandong

doi:10.1111/ecc.12346

Cited by 14 publications

(20 citation statements)

References 39 publications

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“…These associations with tumor characteristics underscore that basal-like tumors tend to have more aggressive characteristics, while luminal A tumors tend to be more indolent. These associations have been relatively consistent across studies and in different racially defined subpopulations [ 25 – 27 ].…”

Section: Discussionmentioning

confidence: 71%

Frequency of breast cancer subtypes among African American women in the AMBER consortium

et al. 2018

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BackgroundBreast cancer subtype can be classified using standard clinical markers (estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2)), supplemented with additional markers. However, automated biomarker scoring and classification schemes have not been standardized. The aim of this study was to optimize tumor classification using automated methods in order to describe subtype frequency in the African American Breast Cancer Epidemiology and Risk (AMBER) consortium.MethodsUsing immunohistochemistry (IHC), we quantified the expression of ER, PR, HER2, the proliferation marker Ki67, and two basal-like biomarkers, epidermal growth factor receptor (EGFR) and cytokeratin (CK)5/6, in 1381 invasive breast tumors from African American women. RNA-based (prediction analysis of microarray 50 (PAM50)) subtype, available for 574 (42%) cases, was used to optimize classification. Subtype frequency was calculated, and associations between subtype and tumor characteristics were estimated using logistic regression.ResultsRelative to ER, PR and HER2 from medical records, central IHC staining and the addition of Ki67 or combined tumor grade improved accuracy for classifying PAM50-based luminal subtypes. Few triple negative cases (< 2%) lacked EGFR and CK5/6 expression, thereby providing little improvement in accuracy for identifying basal-like tumors. Relative to luminal A subtype, all other subtypes had higher combined grade and were larger, and ER-/HER2+ tumors were more often lymph node positive and late stage tumors. The frequency of basal-like tumors was 31%, exceeded only slightly by luminal A tumors (37%).ConclusionsOur findings indicate that automated IHC-based classification produces tumor subtype frequencies approximating those from PAM50-based classification and highlight high frequency of basal-like and low frequency of luminal A breast cancer in a large study of African American women.Electronic supplementary materialThe online version of this article (10.1186/s13058-018-0939-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 71%

Frequency of breast cancer subtypes among African American women in the AMBER consortium

et al. 2018

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“…Other investigators have reported equivalent survival among elderly TNBC patients compared to younger patients despite the reduced rate of treatment with chemotherapy in this age group. [16][17][18] Konigsberg et al observed elderly patients had significantly fewer local, bone and secondary lymph node metastases than younger patients with TNBC. 19 Better survival in older TNBC patients with comparatively less treatment may be related to a less aggressive nature of TNBC in older patients with a decreased likelihood of distant metastases and presentation at lower stage than younger patients.…”

Section: Me Th Odsmentioning

confidence: 99%

Triple-negative breast cancer in the elderly: Prognosis and treatment

Kaplan¹,

Malmgren

Atwood³

2017

Breast J

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Our objective is to characterize treatment of triple-negative breast cancer (TNBC) in older patients and measure mortality risk relative to younger women. We conducted a retrospective cohort study analysis of patients presenting with primary TNBC, age 25-93, stage I-III from 1990 to 2014, identified and tracked by our registry (n=771). Clinical characteristics were chart abstracted at diagnosis and follow-up. The Kaplan-Meier method was used to measure disease-specific survival (DSS) by age with Cox regression modeling for relative contribution of patient and clinical characteristics. Of patients, 80% were <65 years (n=612), 13% were 65-74 years (n=100), and 7% were 75 and older (n=59). Older women presented more often with lower stage BC (stage I: 31% age <65, 48% age 65-74, 39% age 75+; P=.014). All three age groups were equally likely to have radiation therapy (77%) but older patients were less often treated with adjuvant chemotherapy (<65=95%, 65-74=76%, 75+=39%; P<.001). Mean follow-up was 7.34 years and did not differ by age. Five-year DSS was equivalent across the three age groups (<65=85%, 65-74=90%, 75+=83%, P=.322). In Cox regression analysis controlling for stage, histologic and nuclear grade, diagnosis year, radiation and chemotherapy treatment, age was not significantly associated with disease-specific mortality. TNBC survival appears equivalent by age despite less aggressive treatment in patients 75 years and older. This may be a result of lower stage at diagnosis and decreased disease virulence resulting in comparative survival despite less treatment.

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“…Their findings should be transferrable to many other countries and health systems (O'Donovan et al 2015). Chau et al (2015) and Qiu et al (2015) both conducted traditional clinical trials comparing younger and older patients. The latter study looks at differences in clinicopathological features and prognosis of triple-negative breast cancer (TNBC) between younger (<60 years old) and elderly (≥60 years old) patients.…”

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confidence: 99%

“…The retrospective nature of their study and the definition of TNBC is a limitation of the study, and there is definitely a need for more research (funding) in this area in the future so that prospective trials are possible in older patients (Qiu et al . ). Chau et al .…”

mentioning

confidence: 99%

“…They emphasise that physicians need to be careful when choosing adjuvant treatments for older patients with TNBC. The retrospective nature of their study and the definition of TNBC is a limitation of the study, and there is definitely a need for more research (funding) in this area in the future so that prospective trials are possible in older patients (Qiu et al 2015). Chau et al (2015) address clinical outcomes following neoadjuvant cisplatin-based chemotherapy for bladder cancer in both subgroups.…”

mentioning

confidence: 99%

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Integration of geriatric oncology in daily multidisciplinary cancer care: the time is now

Lycke

Pottel

Boterberg

et al. 2015

Eur J Cancer Care (Engl)

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Clinicopathological features and prognosis of triple-negative breast cancer: a comparison between younger (<60) and elderly (≥60) patients

Cited by 14 publications

References 39 publications

Frequency of breast cancer subtypes among African American women in the AMBER consortium

Frequency of breast cancer subtypes among African American women in the AMBER consortium

Triple-negative breast cancer in the elderly: Prognosis and treatment

Integration of geriatric oncology in daily multidisciplinary cancer care: the time is now

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