Basal-Like Breast Cancer; Clinicopathological, Molecular, and Prognostic Features

Sabrine Haddad (1), Ines Zemni (2), Irtyah Merchaoui (3), Ilhem Bettaib (4), Olfa Adouni (5), Riadh Chargui (6), Khaled Ben Rahal (7)
(1) Institut Salah Azaiez, Tunisia,
(2) Salah Azaiez Institute, Tunisia,
(3) Fattouma Bourguiba Hospital, Tunisia,
(4) Salah Azaiez Institute, Tunisia,
(5) Salah Azaiez Institute, Tunisia,
(6) Salah Azaiez Institute, Tunisia,
(7) Salah Azaiez Institute, Tunisia

Abstract

Background: Molecular classification of breast tumors has identified the basal-like subtype, with high heterogeneity and very poor prognosis. These tumors are mainly triple negative, characterized by the expression of basal markers CK5/6 and EGFR. In this study, we sought to investigate the features, outcome, and therapeutic modalities of basal-like breast cancers (BLBC).
Methods: We retrospectively identified 90 BLBC patients diagnosed at the Department of Surgical Oncology of Salah Azaiez Institute between January 2009 and December 2013.
Results: The mean age of our patients was 50 years, and 15.5% had a family history of breast cancer. The mean tumor size was 43.8 mm. Histological examination revealed invasive ductal carcinoma in 88.9% of the cases, metaplastic carcinoma in 5.6%, and medullary carcinoma and adenoid cystic carcinoma in 2.2%. BLBC was most often associated with a high tumor grade (55.3% had a grade 3 tumor) and a high Ki-67 proliferative index. Vascular invasion was found in 31.1% of the cases. Regarding lymph node involvement, 42.9% had positive lymph nodes and 7.9% featured distant metastases. Surgical treatment was provided for 85 patients. It consisted of conservative surgery in 40 cases and radical surgery in 45 cases. Neoadjuvant chemotherapy was administrated to 23 patients, with a 13% complete pathologic response. The rates of overall survival and disease-free survival at 3 years for localized BLBC were 74.4% and 75.9%, respectively.
Conclusion: BLBCs are aggressive tumors associated with poor prognosis. Thus, to identify novel prognostic factors and therapeutic targets, prospective studies should investigate the epidemiological and evolutive profile of these tumors.

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References

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. janv 2018;68(1):7?30.
2. Perou CM, Sørlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, et al. Molecular portraits of human breast tumours. Nature. août 2000;406(6797):747?52.
3. Toft DJ, Cryns VL. Minireview: Basal-Like Breast Cancer: From Molecular Profiles to Targeted Therapies. Mol Endocrinol. févr 2011;25(2):199?211.
4. Lehmann BD, Bauer JA, Chen X, Sanders ME, Chakravarthy AB, Shyr Y, et al. Identification of human triple-negative breast cancer subtypes and preclinical models for selection of targeted therapies. J Clin Invest. juill 2011;121(7):2750?67.
5. Nielsen TO, Hsu FD, Jensen K, Cheang M, Karaca G, Hu Z, et al. Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res Off J Am Assoc Cancer Res. août 2004;10(16):5367?74.
6. Ghosn M, Hajj C, Kattan J, Farhat F, El Karak F, Nasr F, et al. Triple-Negative Breast Cancer in Lebanon: A Case Series. The Oncologist. nov 2011;16(11):1552?6.
7. Dent R, Hanna WM, Trudeau M, Rawlinson E, Sun P, Narod SA. Time to disease recurrence in basal-type breast cancers: effects of tumor size and lymph node status. Cancer.nov 2009;115(21):4917?23.
8. Rakha EA, Putti TC, Abd El-Rehim DM, Paish C, Green AR, Powe DG, et al. Morphological and immunophenotypic analysis of breast carcinomas with basal and myoepithelial differentiation. J Pathol. mars 2006;208(4):495?506.
9. Cherbal F, Gaceb H, Mehemmai C, Saiah I, Bakour R, Rouis AO, et al. Distribution of molecular breast cancer subtypes among Algerian women and correlation with clinical and tumor characteristics: a population-based study. Breast Dis. 2015;35(2):95?102.
10. Qiu J, Xue X, Hu C, Xu H, Kou D, Li R, et al. Comparison of Clinicopathological Features and Prognosis in Triple-Negative and Non-Triple Negative Breast Cancer. J Cancer. janv 2016;7(2):167?73.
11. Rakha EA, Elsheikh SE, Aleskandarany MA, Habashi HO, Green AR, Powe DG, et al. Triple-negative breast cancer: distinguishing between basal and nonbasal subtypes. Clin Cancer Res Off J Am Assoc Cancer Res. avr 2009;15(7):2302?10.
12. Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V. Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California cancer Registry. Cancer. mai 2007;109(9):1721?8.
13. Masili-Oku SM, Almeida BGL de, Bacchi CE, Filassi JR, Baracat EC, Carvalho FM. Lymphocyte-predominant triple-negative breast carcinomas in premenopausal patients: Lower expression of basal immunohistochemical markers. Breast Edinb Scotl. févr 2017;31:34?9.
14. Byrski T, Huzarski T, Dent R, Marczyk E, Jasiowka M, Gronwald J, et al. Pathologic complete response to neoadjuvant cisplatin in BRCA1-positive breast cancer patients. Breast Cancer Res Treat. sept 2014;147(2):401?5.
15. Clifton K, Gutierrez-Barrera A, Ma J, Bassett R, Litton J, Kuerer H, et al. Adjuvant versus neoadjuvant chemotherapy in triple-negative breast cancer patients with BRCA mutations. Breast Cancer Res Treat. 22 févr 2018;
16. Gao B, Zhang H, Zhang S-D, Cheng X-Y, Zheng S-M, Sun Y-H, et al. Mammographic and clinicopathological features of triple-negative breast cancer. Br J Radiol. juill 2014;87(1039):20130496.
17. Kim MY, Choi N. Mammographic and ultrasonographic features of triple-negative breast cancer: a comparison with other breast cancer subtypes. Acta Radiol Stockh Swed 1987. oct 2013;54(8):889?94.
18. Domingo L, Salas D, Zubizarreta R, Baré M, Sarriugarte G, Barata T, et al. Tumor phenotype and breast density in distinct categories of interval cancer: results of population-based mammography screening in Spain. Breast Cancer Res BCR. 10 janv 2014;16(1):R3.
19. Badowska-Kozakiewicz AM, Budzik MP. Immunohistochemical characteristics of basal-like breast cancer. Contemp Oncol. 2016;20(6):436?43.
20. Wang W, Wu J, Zhang P, Fei X, Zong Y, Chen X, et al. Prognostic and predictive value of Ki-67 in triple-negative breast cancer. Oncotarget. 24 mai 2016;7(21):31079?87.
21. Berruti A, Amoroso V, Gallo F, Bertaglia V, Simoncini E, Pedersini R, et al. Pathologic complete response as a potential surrogate for the clinical outcome in patients with breast cancer after neoadjuvant therapy: a meta-regression of 29 randomized prospective studies. J Clin Oncol Off J Am Soc Clin Oncol. déc 2014;32(34):3883?91.
22. Fayaz MS, El-Sherify MS, El-Basmy A, Zlouf SA, Nazmy N, George T, et al. Clinicopathological features and prognosis of triple negative breast cancer in Kuwait: A comparative/perspective analysis. Rep Pract Oncol Radiother J Gt Cancer Cent Poznan Pol Soc Radiat Oncol. mai 2014;19(3):173?81.
23. Liedtke C, Mazouni C, Hess KR, André F, Tordai A, Mejia JA, et al. Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. J Clin Oncol Off J Am Soc Clin Oncol. mars 2008;26(8):1275?81.
24. Voduc KD, Cheang MCU, Tyldesley S, Gelmon K, Nielsen TO, Kennecke H. Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol Off J Am Soc Clin Oncol. avr 2010;28(10):1684?91.
25. Liedtke C, Hess KR, Karn T, Rody A, Kiesel L, Hortobagyi GN, et al. The prognostic impact of age in patients with triple-negative breast cancer. Breast Cancer Res Treat. avr 2013;138(2):591?9.
26. Luck AA, Evans AJ, Green AR, Rakha EA, Paish C, Ellis IO. The influence of basal phenotype on the metastatic pattern of breast cancer. Clin Oncol R Coll Radiol G B. févr 2008;20(1):40?5.
27. Gonçalves A. [PARP inhibitors and breast cancer: update and perspectives]. Bull Cancer (Paris). avr 2012;99(4):441?51.
28. Khosravi-Shahi P, Cabezón-Gutiérrez L, Custodio-Cabello S. Metastatic triple negative breast cancer: Optimizing treatment options, new and emerging targeted therapies. Asia Pac J Clin Oncol. août 2017;
29. Clifton K, Gutierrez-Barrera A, Ma J, Bassett R, Litton J, Kuerer H, et al. Adjuvant versus neoadjuvant chemotherapy in triple-negative breast cancer patients with BRCA mutations. Breast Cancer Res Treat. févr 2018;
30. Hurvitz S, Mead M. Triple-negative breast cancer: advancements in characterization and treatment approach. Curr Opin Obstet Gynecol. févr 2016;28(1):59?69.

Authors

Sabrine Haddad
sabriinea@yahoo.com (Primary Contact)
Ines Zemni
Irtyah Merchaoui
Ilhem Bettaib
Olfa Adouni
Riadh Chargui
Khaled Ben Rahal
1.
Haddad S, Zemni I, Merchaoui I, Bettaib I, Adouni O, Chargui R, Ben Rahal K. Basal-Like Breast Cancer; Clinicopathological, Molecular, and Prognostic Features . Arch Breast Cancer [Internet]. 2019 May 31 [cited 2024 Jul. 16];:85-91. Available from: https://archbreastcancer.com/index.php/abc/article/view/242

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