Triple-Negative versus Non–Triple-Negative Breast Cancers in High-Risk Women: Phenotype Features and Survival from the HIBCRIT-1 MRI-Including Screening Study

Abstract

Purpose: To compare phenotype features and survival of triple-negative breast cancers (TNBC) versus non-TNBCs detected during a multimodal annual screening of high-risk women.Experimental Design: Analysis of data from asymptomatic high-risk women diagnosed with invasive breast cancer during the HIBCRIT-1 study with median 9.7-year follow-up.Results: Of 501 enrolled women with BRCA1/2 mutation or strong family history (SFH), 44 were diagnosed with invasive breast cancers: 20 BRCA1 (45%), 9 BRCA2 (21%), 15 SFH (34%). Magnetic resonance imaging (MRI) sensitivity (90%) outperformed that of mammography (43%, P < 0.001) and ultrasonography (61%, P ¼ 0.004). The 44 cases (41 screen-detected; 3 BRCA1-associated interval TNBCs) comprised 14 TNBCs (32%) and 30 non-TNBCs (68%), without significant differences for age at diagnosis, menopausal status, prophylactic oophorectomy, or previous breast cancer. Of 14 TNBC patients, 11 (79%) were BRCA1; of the 20 BRCA1 patients, 11 (55%) had TNBC; and of 15 SFH patients, 14 (93%) had non-TNBCs (P ¼ 0.007). Invasive ductal carcinomas (IDC) were 86% for TNBCs versus 43% for non-TNBCs (P ¼ 0.010), G3 IDCs 71% versus 23% (P ¼ 0.006), size 16 AE 5 mm versus 12 AE 6 mm (P ¼ 0.007). TNBC patients had more frequent ipsilateral mastectomy (79% vs. 43% for nonTNBCs, P ¼ 0.050), contralateral prophylactic mastectomy (43% vs. 10%, P ¼ 0.019), and adjuvant chemotherapy (100% vs. 44%, P < 0.001). The 5-year overall survival was 86% AE 9% for TNBCs versus 93% AE 5% (P ¼ 0.946) for non-TNBCs; 5-year disease-free survival was 77% AE 12% versus 76% AE 8% (P ¼ 0.216).Conclusions: In high-risk women, by combining an MRIincluding annual screening with adequate treatment, the usual reported gap in outcome between TNBCs and non-TNBCs could be reduced. Clin Cancer Res; 22(4); 895-904. Ó2015 AACR.

Contrast‐enhanced MRI for breast cancer screening

“…Still, Moller et al report a 10‐year survival of only 69% for BRCA1 mutation carriers participating in an MRI‐based screening program, which points to the still much worse outcome in this specific population . Podo et al, however, showed that the 5‐year overall survival difference between triple‐negative breast cancers and less aggressive subtypes was relatively small (86% ± 9% for TNBCs vs. 93% ± 5% for others) in patients who participated in the HIBCRIT‐1 trial …”

“…53 Podo et al, however, showed that the 5-year overall survival difference between triple-negative breast cancers and less aggressive subtypes was relatively small (86% AE 9% for TNBCs vs. 93% AE 5% for others) in patients who participated in the HIBCRIT-1 trial. 54…”

Silver nanoparticles selectively treat triple‐negative breast cancer cells without affecting non‐malignant breast epithelial cells in vitro and in vivo

“…As a consequence, TNBC patients do not benefit from modern receptor‐targeted therapies . Moreover, TNBC patients have a significantly higher risk of recurrence and death than patients with other types of breast cancer . Disease heterogeneity has limited the development of molecularly targeted therapeutics .…”

“…1 Moreover, TNBC patients have a significantly higher risk of recurrence and death than patients with other types of breast cancer. 2 Disease heterogeneity has limited the development of molecularly targeted therapeutics. 3 The current standard of care for TNBC involves surgical resection of the primary tumor preceded or followed by ionizing radiation and a cocktail of chemotherapies.…”

Clinical Breast MR Using MRS or DWI: Who Is the Winner?

“…This approach was further developed as bilateral highly spatially resolved contrast-enhanced (CE) dynamic study, which is now currently considered superior for breast cancer (BC) detection to any other imaging technique with a reported pooled sensitivity and specificity of 93.2 and 71.1%, respectively (2), as also shown by studies on MRI screening of women at increased risk of BC (3–6). In fact, CE-MRI provides a physiopathological information that correlates with increased vascularity, vascular permeability, and interstitial space in malignant tissue, not available from mammography and ultrasound.…”