Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis

Sanges, Francesca; Floris, Matteo; Cossu-Rocca, Paolo; Muroni, Maria Rosaria; Pira, Giovanna; Urru, Silvana Anna Maria; Barrocu, Renata; Gallus, Silvano; Bosetti, Cristina; D’Incalci, Maurizio; Manca, Alessandra; Uras, Maria Gabriela; Medda, Ricardo; Sollai, Elisabetta; Murgia, Alma; Palmas, Dolores; Atzori, Francesco; Zinellu, Angelo; Cambosu, Francesca; Moi, Tiziana; Ghiani, M.; Marras, Vincenzo; Santona, Maria Cristina; Canu, L; Valle, Elisabetta Della; Sarobba, Maria Giuseppina; Onnis, Daniela; Asunis, Anna Maria; Cossú, Sergio F.; Orrù, Sandra; Miglio, Maria Rosaria De

doi:10.1186/s12885-020-06998-9

Cited by 24 publications

(21 citation statements)

References 53 publications

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“…In a study by Francesca et al, triple negative ILC showed the worst survival outcomes (79.7% at 5-years and 73.8% at 10-years) among all histological types. The same study reported that triple negative ILC showed a higher metastatic lymph node ratio (> 0.65) and lower response to chemotherapy than those of other triple negative breast cancer histological types [ 20 ]. It is hard to predict outcomes based on current classification and treatment regimens because the ER−/PR− population shows heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

Survival analysis in patients with invasive lobular cancer and invasive ductal cancer according to hormone receptor expression status in the Korean population

Kwon

Ko²,

Jung³

et al. 2022

PLoS ONE

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Background We compared the clinicopathological characteristics and survival outcomes of invasive lobular carcinoma (ILC) cases with those of invasive ductal carcinoma (IDC) cases in various hormone receptor expression subgroups. Methods We compared clinicopathological characteristics, overall survival (OS), and breast cancer-specific survival (BCSS) between patients with IDC (n = 95,486) and ILC (n = 3,023). In addition, we analyzed the effects of different hormone receptor expression subgroups on survival. Results The ILC group had more instances of advanced stage and hormonal receptor positivity than did the IDC group (p < 0.001), but the IDC group had higher histological grade and nuclear grade, as well as higher frequency of human epidermal growth factor receptor 2 and Ki67 expression than did the ILC group (p < 0.001). The OS and BCSS were not significantly different between the IDC and ILC groups. The 5-year OS of the IDC group was 88.8%, while that of the ILC group was 90.6% (p = 0.113). The 5-year BCSS of the IDC group was 94.8%, while that of the ILC group was 95.0% (p = 0.552). When analyzing each hormone receptor expression subgroup, there were no significant differences in survival between the IDC and ILC groups. However, the estrogen receptor (ER) negative/progesterone receptor (PR) negative subgroup showed differences in survival between the IDC and ILC groups. Moreover, the hazard ratio of ILC in the ER negative/PR negative subgroup was 1.345 (95% confidence interval: 1.012–1.788; p = 0.041). Conclusions Hormone receptor expression should be considered when determining prognosis and treatment regimen for IDC and ILC. Researchers should further study the ER negative/PR negative population to identify treatment and prognostic models that will facilitate the development of individualized therapy for these patients, which is needed for good outcomes.

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Section: Discussionmentioning

confidence: 99%

Survival analysis in patients with invasive lobular cancer and invasive ductal cancer according to hormone receptor expression status in the Korean population

Kwon

Ko²,

Jung³

et al. 2022

PLoS ONE

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“…The IM subtype is enhanced in immune cell processes (cell and cytokine signaling, antigen processing, and presentation) and signaling by transduction of the immune signal of the nucleus. IM GO overlaps with a gene signature for medullary BC, an unusual, high-grade histologic TNBC subtype showing favorable prognosis [7,28]. The M and MSL subtype GOs are enriched in cell motility, extracellular matrix (ECM) receptor interaction, and cell differentiation.…”

Section: Molecular Classifications Of Tnbc: Clinical Outcome Implicatmentioning

confidence: 99%

“…TNBC shows different molecular and clinicopathological features [6] and is histologically categorized as a high-grade invasive BC of no special type. "Special types" are still included into the TNBC subtype but differ in biological behavior and clinical course [7].…”

Section: Introductionmentioning

confidence: 99%

Modulatory Role of microRNAs in Triple Negative Breast Cancer with Basal-Like Phenotype

Angius

Cossu-Rocca

Arru

et al. 2020

Cancers

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Development of new research, classification, and therapeutic options are urgently required due to the fact that TNBC is a heterogeneous malignancy. The expression of high molecular weight cytokeratins identifies a biologically and clinically distinct subgroup of TNBCs with a basal-like phenotype, representing about 75% of TNBCs, while the remaining 25% includes all other intrinsic subtypes. The triple negative phenotype in basal-like breast cancer (BLBC) makes it unresponsive to endocrine therapy, i.e., tamoxifen, aromatase inhibitors, and/or anti-HER2-targeted therapies; for this reason, only chemotherapy can be considered an approach available for systemic treatment even if it shows poor prognosis. Therefore, treatment for these subgroups of patients is a strong challenge for oncologists due to disease heterogeneity and the absence of unambiguous molecular targets. Dysregulation of the cellular miRNAome has been related to huge cellular process deregulations underlying human malignancy. Consequently, epigenetics is a field of great promise in cancer research. Increasing evidence suggests that specific miRNA clusters/signatures might be of clinical utility in TNBCs with basal-like phenotype. The epigenetic mechanisms behind tumorigenesis enable progress in the treatment, diagnosis, and prevention of cancer. This review intends to summarize the epigenetic findings related to miRNAome in TNBCs with basal-like phenotype.

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Section: Introductionmentioning

confidence: 99%

“…Breast cancer (BC) is a heterogeneous disease enclosing several entities with different morphologic, prognostic and therapeutic features [ 1 ]. Invasive breast cancer is classified according to histology and immunohistochemistry (i.e., ER, PR, HER2 overexpression, and/or HER2 gene amplification, and Ki67 proliferation index) [ 1 , 2 ]. Surrogate molecular classification of BC by means of immunohistochemistry defines specific subtypes, such as Luminal A (ER and PR positive, HER2 negative, low Ki67), Luminal B (ER positive, PR positive/negative, HER2 negative, high Ki67), Luminal B HER2+ (ER positive, PR positive/negative, HER2 positive, any Ki67), HER2+ non-luminal (ER-PR negative, HER2 positive, high Ki67), and triple negative (ER-PR-HER2 negative, high Ki67) [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Role of Androgen Receptor Expression in HER2+ Breast Carcinoma Subtypes

et al. 2022

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HER2+ breast cancer (BC) is an aggressive subtype representing a genetically and biologically heterogeneous group of tumors resulting in variable prognosis and treatment response to HER2-targeted therapies according to estrogen (ER) and progesterone receptor (PR) expression. The relationship with androgen receptors (AR), a member of the steroid hormone’s family, is unwell known in BC. The present study aims to evaluate the prognostic impact of AR expression in HER2+ BC subtypes. A total of 695 BCs were selected and reviewed, AR, ER, PR and HER2 expression in tumor cells were examined by immunohistochemical method, and the SISH method was used in case of HER2 with equivocal immunohistochemical score (2+). A high prevalence of AR expression (91.5%) in BC HER+ was observed, with minimal differences between luminal and non-luminal tumor. According to steroid receptor expression, tumors were classified in four subgroups, including BC luminal and non-luminal HER2+ expressing or not AR. The luminal BC HER2 + AR+ was associated with lower histological grade, lower tumor size, higher PR expression and lower HER2 intensity of expression (2+). Also, the non-luminal tumors AR+ showed lower tumor size and lower prognostic stage but frequently higher grade and higher HER2 intensity of expression (3+). These findings should suggest a different progression of luminal and non-luminal tumors, both expressing AR, and allow us to speculate that the molecular mechanisms of AR, involved in the biology of BC HER2 + AR+, differ in relation to ER and PR expression. Moreover, AR expression may be a useful predictor of prognosis for overall survival (OS) in HER2+ BC subtypes. Our findings suggest that AR expression evaluation in clinical practice could be utilized in clinical oncology to establish different aggressiveness in BC HER2+ subtypes.

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Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis

Cited by 24 publications

References 53 publications

Survival analysis in patients with invasive lobular cancer and invasive ductal cancer according to hormone receptor expression status in the Korean population

Survival analysis in patients with invasive lobular cancer and invasive ductal cancer according to hormone receptor expression status in the Korean population

Modulatory Role of microRNAs in Triple Negative Breast Cancer with Basal-Like Phenotype

Prognostic Role of Androgen Receptor Expression in HER2+ Breast Carcinoma Subtypes

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