Clinical and pathological characteristics of triple-negative breast cancer patients: A single-center experience
Abstract
Aim: Triple negative
breast cancer in which estrogen, progesterone receptors and c-erbB2
overexpression are negative, seems to have different clinical course and
recurrence pattern. We retrospectively evaluated clinical demographic and
pathological characteristics of triple negative breast cancers and investigated
the association of these characteristics with OS and PFS, and also we aimed to
identify prognostic factors, chemotherapy effects, survival rates, and the
factors that effect survival rates.
cancer patients followed in Başkent University Hospital between 1997-2009 were
evoluated retrospectively. Results: The median age of
patients was 49. Median follow-up duration was 27 months (0.27-132 months). Two
patients died during the follow-up. Invasive ductal carcinoma pathology was
reported in 38 patients, invasive lobular in 3 patients, medullary in 5
patients. Almost half of the patients had LVI. 79% of patients had a T2
disease. 30% of patients’ tumor histological grade was III. Cancer history in
the family was present in 95% of patients. Almost half of the patients had
stage II disease. Adjuvant chemotherapy was given to 43 patients. Relapses were
observed in 15 patients.The most common metastatic site was lung. Patients
having high grade tumor, >3 (+) lymph nodes, younger age have higher chance
of relapse during follow-up. Conclusions:
In accordance with the literature, our triple negative breast cancer patients
showed more aggressive characteristics. Although median follow-up is short,
one-fourth of the patients having recurrence support natue of the triple
negative breast cancer patients. In our study, triple negative patients had
younger age at diagnosis, high grade tumors and more tendency to metastasize to
visceral organs.
References
- 1. Parkin DM, Bray F, Ferlay J, Pisani P.Estimating the world cancer burden:Globocan 2000. Int J Cancer. 2001; 94: 153-156.
- 2. Rosen PP Immunohistochemical detection of HER-2/neu in patients withaxillary lymph node negative breast carcinoma cancer. BMJ. 1995; 75: 1320-6.
- 3. Surveillance, Epidemiology, and End Results Program (SEER) SEER StatDatabase: Mortality—All COD, Public-Use With State, Total U.S. for ExpandedRaces/Hispanics (1990-2001). National Cancer Institute, DCCPS, SurveillanceResearch Program, Cancer Statistics Branch, released April 2004http://www.seer.cancer.gov.
- 4. Sorlie T, Perou CM, Tibshirani R. Gene expression patterns of breastcarcinomas distinguish tumor subclasses with clinical implications. Proc NatlAcad Sci USA 2001;98:10869–74.
- 5. Sorlie T, Tibshirani R, Parker J Repeated observation of breast tumor subtypesin independent gene expression data sets. Proc Natl Acad Sci USA2003;100:8418–23.
- 6. Gusterson A.B,Ross T.D, Heath J.V,Stein T.Basal cytokeratins and theirrelationship to the cellular origin and functional classification of breastcancer.Breast cancer reseach 2005,7:143- 148.
- 7. Rakha A.E, El Sayed E.A, Green R.A, Lee H.S.A Prognostic markers in Triple –Negative Breast Cancers.Cancer.January, 2007.Vol.109/numb
- 8Fulford LG, Easton DF, Reis- Filho JS, Specific morphological featurepredictive for the basal phenotype in grade 3 invasive ductal carcinoma ofbreast. Histopathology 2006,49, 22-34.10.
- 9. O.Gluz,C.Liedtke,N.Gottschalk,L.Pusztai,U.Nitz,N.Harbeck.Triple-negativebreast cancer- current status and future directions.Annal of Oncology AdvanceAccess Published November 9,2009
- 10 . Demographic, clinical, and pathological characteristics of Turkish triplenegativebreast cancer patients: single center experience S. Aksoy, O. Dizdar, H.Harputluoglu, K. Altundag* Ann Oncol (2007) 18 (11): 1904-1906.
- 11 . Triple-Negative Breast Cancer: Clinical Features and Patterns of RecurrenceRebecca Dent,1Maureen Trudeau,1Kathleen I. Pritchard,1WedadM.Hanna,1Harriet K. Kahn,1 Carol A. Sawka,1Lavina A. Lickley,1EllenRawlinson,2 Ping Sun,2 and Steven A. Narod2 Clinical Cancer ResearchAugust 2007 13; 4429
- 12. Hua Cao, Maosheng Yan, Shubin Wang, Tao Zheng, Ruilian Xu, Yixin Chenand Yajie Liu The Second Clinical Medicine College, Jinan University,Shenzhen, 518020, China.
- 13. Descriptive Analysis of Estrogen Receptor (ER)-Negative, ProgesteroneReceptor (PR)-Negative, and HER2-Negative Invasive Breast Cancer, the SocalledTriple-Negative Phenotype A Population-Based Study From theCalifornia Cancer Registry Katrina R. Bauer, MS CTR 1, Monica Brown, PhD2, Rosemary D. Cress, DrPH1,3, Carol A. Parise, PhD4, Vincent Caggiano, MD4,5. Volume 109 Issue 9, Pages 1697 - 1950 (1 May 2007)
- 14. M Abeloff, J Armitage, J Niederhuber, M Kastan, WG McKenna ClinicalOncology Textbook 3rd edition
- 15 . Venkitaraman R, Joseph T, Dhadda A, et al. Prognosis of patients with triplenegativebreast cancer and brain metastasis. Clin Oncol (R Coll Radiol) 2009;21:729-30.16. Nielsen TO, Hsu FD, Jensen K, et al. Immunohistochemical and clinicalcharacterization of the basal-like subtype of invasive breast carcinoma. ClinCancer Res 2004;10:5367–74.17. Carey LA, Perou CM, Livasy CA, et al.: Race, breast cancer subtypes, andsurvival in the Carolina Breast Cancer Study. JAMA 2006;295:2492-502
- 18 . Dent R, Trudeau M, Pritchard KI, et al.: Triple-negative breast cancer: clinicalfeatures and patterns of recurrence. Clin Cancer Res 2007; 13:4429-34
- 19. Half E, Tang XM, Gwyn K, et al. Cyclooxygenase-2 expression in human breastcancers and adjacent ductal carcinomas in situ. Cancer Res. 2002; 62:1676-81
- 20Bos PD, Zhang XH, Nadal C, Shu W, et al. Genes that mediate breast cancermetastasis to the brain. Nature. 2009; 459:1005-9
- 21. Holmes MD, Chen WY, Li L, Hertzmark E, Spiegelman D, Hankinson SE:Aspirin Intake and Survival After Breast Cancer. J Clin Oncol. 2010 Feb 16.[Epub ahead of print]
- 22. Arslan C, Dizdar O, Altundag K. Estrogen receptor immunohistochemistrycutoff value: standardization is needed. Hum Pathol. 2010 Jan;41(1):150;
- 23. Carey LA, Dees EC, Sawyer LR, et al. The triple negative paradox: primarytumor chemosensitivity of the basal-like breast cancer phenotype. Breast CancerRes Treat 2004;80:1023.
- 24. Rouzier R, Perou CM, Symmans WF, et al. Breast cancer molecular subtypesrespond differently to preoperative chemotherapy. Clin Cancer Res2005;11:5678–8.
Abstract
Giriş: Östrojen
progesteron ve c-erbB2 ekspresyonu negatif olan üçlü negatif meme kanserleri,
diğer meme kanser türlerine göre daha kötü prognoza sahiptir. Bu çalışmada üçlü
negatif meme kanserlerinin klinik demografik ve patolojik karakteristikleri ve
bu karakteristiklerin genel sağkalım ve progresyonsuz sağkalımla olan ilişkisi
retrospektif olarak incelenerek prognostik faktörler, kemoterapi etkinlikleri
ve sağkalım oranları ile sağkalıma etki eden faktörlerin
belirlenmesi amaçlanmıştır. Yöntem: Başkent Üniversitesi Hastanesinde 1997-2009 arasında takipli
üçlü negatif meme kanserli hasta retrospektif olarak incelendi. Bulgular: Hastaların median yaşları 49
idi. Median takip süresi 27 ay idi (0.27-132 ay). İki hasta takip sırasında ex
oldu. 38 hastada invaziv duktal karsinom, üç hastada invaziv lobuler karsinom,
beş hastada meduller karsinom saptandı. Hastaların neredeyse yarısında lenf
nodu invazyonu vardı. %79 hastanın T2 hastalığı vardı. Hastaların %30 unun
tümör histolojik derece III, ve neredeyse yarısında evre II hastalık vardı. %95
inde ailede kanser öyküsü mevcuttu. Adjuvan kemoterapi 43 hastaya verildi. 15
hastada relaps gözlendi. En sık metastaz akciğere idi. Yüksek dereceli tümörü
olan, üçden fazla lenf nodu tutulan, ve genç yaşta olanların takiplerde daha
fazla relaps olduğu görüldü. Tartışma:
Literatürle uyumlu bir şekilde, bizim üçlü negatif meme kanserli hastalarımız
da agresif karakteristikliydi. Median takip süresi kısa olmasına rağmen üçlü
negatif meme kanserli hastaların doğasını destekleyecek şekilde ¼ hastada
rekürrens izlendi. Çalışmamızda hastalarımız daha genç yaşta tanı almış, yüksek
dereceli tümörlü ve visseral organlara metastaz yapma eğilimleri daha fazla idi.
References
- 1. Parkin DM, Bray F, Ferlay J, Pisani P.Estimating the world cancer burden:Globocan 2000. Int J Cancer. 2001; 94: 153-156.
- 2. Rosen PP Immunohistochemical detection of HER-2/neu in patients withaxillary lymph node negative breast carcinoma cancer. BMJ. 1995; 75: 1320-6.
- 3. Surveillance, Epidemiology, and End Results Program (SEER) SEER StatDatabase: Mortality—All COD, Public-Use With State, Total U.S. for ExpandedRaces/Hispanics (1990-2001). National Cancer Institute, DCCPS, SurveillanceResearch Program, Cancer Statistics Branch, released April 2004http://www.seer.cancer.gov.
- 4. Sorlie T, Perou CM, Tibshirani R. Gene expression patterns of breastcarcinomas distinguish tumor subclasses with clinical implications. Proc NatlAcad Sci USA 2001;98:10869–74.
- 5. Sorlie T, Tibshirani R, Parker J Repeated observation of breast tumor subtypesin independent gene expression data sets. Proc Natl Acad Sci USA2003;100:8418–23.
- 6. Gusterson A.B,Ross T.D, Heath J.V,Stein T.Basal cytokeratins and theirrelationship to the cellular origin and functional classification of breastcancer.Breast cancer reseach 2005,7:143- 148.
- 7. Rakha A.E, El Sayed E.A, Green R.A, Lee H.S.A Prognostic markers in Triple –Negative Breast Cancers.Cancer.January, 2007.Vol.109/numb
- 8Fulford LG, Easton DF, Reis- Filho JS, Specific morphological featurepredictive for the basal phenotype in grade 3 invasive ductal carcinoma ofbreast. Histopathology 2006,49, 22-34.10.
- 9. O.Gluz,C.Liedtke,N.Gottschalk,L.Pusztai,U.Nitz,N.Harbeck.Triple-negativebreast cancer- current status and future directions.Annal of Oncology AdvanceAccess Published November 9,2009
- 10 . Demographic, clinical, and pathological characteristics of Turkish triplenegativebreast cancer patients: single center experience S. Aksoy, O. Dizdar, H.Harputluoglu, K. Altundag* Ann Oncol (2007) 18 (11): 1904-1906.
- 11 . Triple-Negative Breast Cancer: Clinical Features and Patterns of RecurrenceRebecca Dent,1Maureen Trudeau,1Kathleen I. Pritchard,1WedadM.Hanna,1Harriet K. Kahn,1 Carol A. Sawka,1Lavina A. Lickley,1EllenRawlinson,2 Ping Sun,2 and Steven A. Narod2 Clinical Cancer ResearchAugust 2007 13; 4429
- 12. Hua Cao, Maosheng Yan, Shubin Wang, Tao Zheng, Ruilian Xu, Yixin Chenand Yajie Liu The Second Clinical Medicine College, Jinan University,Shenzhen, 518020, China.
- 13. Descriptive Analysis of Estrogen Receptor (ER)-Negative, ProgesteroneReceptor (PR)-Negative, and HER2-Negative Invasive Breast Cancer, the SocalledTriple-Negative Phenotype A Population-Based Study From theCalifornia Cancer Registry Katrina R. Bauer, MS CTR 1, Monica Brown, PhD2, Rosemary D. Cress, DrPH1,3, Carol A. Parise, PhD4, Vincent Caggiano, MD4,5. Volume 109 Issue 9, Pages 1697 - 1950 (1 May 2007)
- 14. M Abeloff, J Armitage, J Niederhuber, M Kastan, WG McKenna ClinicalOncology Textbook 3rd edition
- 15 . Venkitaraman R, Joseph T, Dhadda A, et al. Prognosis of patients with triplenegativebreast cancer and brain metastasis. Clin Oncol (R Coll Radiol) 2009;21:729-30.16. Nielsen TO, Hsu FD, Jensen K, et al. Immunohistochemical and clinicalcharacterization of the basal-like subtype of invasive breast carcinoma. ClinCancer Res 2004;10:5367–74.17. Carey LA, Perou CM, Livasy CA, et al.: Race, breast cancer subtypes, andsurvival in the Carolina Breast Cancer Study. JAMA 2006;295:2492-502
- 18 . Dent R, Trudeau M, Pritchard KI, et al.: Triple-negative breast cancer: clinicalfeatures and patterns of recurrence. Clin Cancer Res 2007; 13:4429-34
- 19. Half E, Tang XM, Gwyn K, et al. Cyclooxygenase-2 expression in human breastcancers and adjacent ductal carcinomas in situ. Cancer Res. 2002; 62:1676-81
- 20Bos PD, Zhang XH, Nadal C, Shu W, et al. Genes that mediate breast cancermetastasis to the brain. Nature. 2009; 459:1005-9
- 21. Holmes MD, Chen WY, Li L, Hertzmark E, Spiegelman D, Hankinson SE:Aspirin Intake and Survival After Breast Cancer. J Clin Oncol. 2010 Feb 16.[Epub ahead of print]
- 22. Arslan C, Dizdar O, Altundag K. Estrogen receptor immunohistochemistrycutoff value: standardization is needed. Hum Pathol. 2010 Jan;41(1):150;
- 23. Carey LA, Dees EC, Sawyer LR, et al. The triple negative paradox: primarytumor chemosensitivity of the basal-like breast cancer phenotype. Breast CancerRes Treat 2004;80:1023.
- 24. Rouzier R, Perou CM, Symmans WF, et al. Breast cancer molecular subtypesrespond differently to preoperative chemotherapy. Clin Cancer Res2005;11:5678–8.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 31, 2019 |
| Submission Date | March 15, 2019 |
| Acceptance Date | October 7, 2019 |
| Published in Issue | Year 2019 Volume: 12 Issue: 3 |
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MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.
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