scholarly journals Triple-Negative Breast Cancer Histological Subtypes with a Favourable Prognosis

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5694
Author(s):  
Gábor Cserni ◽  
Cecily M. Quinn ◽  
Maria Pia Foschini ◽  
Simonetta Bianchi ◽  
Grace Callagy ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Working Group ◽  
Triple Negative ◽  
Metaplastic Carcinoma ◽  
Classical Type ◽  
Low Grade ◽  
Breast Cancers ◽  
Rare Tumour ◽  
Molecular Features ◽  
European Working

Triple-negative breast cancers (TNBC), as a group of tumours, have a worse prognosis than stage-matched non-TNBC and lack the benefits of routinely available targeted therapy. However, TNBC is a heterogeneous group of neoplasms, which includes some special type carcinomas with a relatively indolent course. This review on behalf of the European Working Group for Breast Screening Pathology reviews the literature on the special histological types of BC that are reported to have a triple negative phenotype and indolent behaviour. These include adenoid cystic carcinoma of classical type, low-grade adenosquamous carcinoma, fibromatosis-like metaplastic carcinoma, low-grade mucoepidermoid carcinoma, secretory carcinoma, acinic cell carcinoma, and tall cell carcinoma with reversed polarity. The pathological and known molecular features as well as clinical data including treatment and prognosis of these special TNBC subtypes are summarised and it is concluded that many patients with these rare TNBC pure subtypes are unlikely to benefit from systemic chemotherapy. A consensus statement of the working group relating to the multidisciplinary approach and treatment of these rare tumour types concludes the review.

Spindle Cell Metaplastic Breast Carcinoma

2021 ◽  
Vol 17 ◽  
Author(s):  
Vithya Sanmugasiva ◽  
Marlina Tanty Ramli Hamid ◽  
Farhana Fadzli ◽  
Nazimah Ab Mumin ◽  
Kartini Rahmat
Keyword(s):  
Breast Carcinoma ◽  
Cell Carcinoma ◽  
Spindle Cell ◽  
Final Diagnosis ◽  
Spindle Cell Carcinoma ◽  
Left Breast ◽  
Metaplastic Carcinoma ◽  
Breast Cancers ◽  
Breast Lump ◽  
Metaplastic Breast Carcinoma

Introduction: Metaplastic breast carcinoma is an uncommon malignancy that constitutes < 5% of all breast cancers. There are 5 subtypes which are spindle cell, squamous cell, carcinosarcoma, matrix-producing and metaplastic with osteoclastic giant cells. Spindle cell carcinoma represents approximately <0.3% of invasive breast carcinomas. It is typically a triple-negative cancer with distinct pathological characteristics, but relatively a non-conclusive imaging findings. Case report: An elderly lady presented with an enlarging painful left breast lump for 1 year. Palpable left breast lump noted on clinical examination. Mammography demonstrated a high density, oval lesion with a partially indistinct margin. Corresponding ultrasound showed a large irregular heterogeneous lesion with solid-cystic areas. Histopathology showed atypical spindle-shaped cells which stained positive for cytokeratins and negative for hormone and human epidermal growth factor receptors, which favours spindle cell metaplastic carcinoma. Left mastectomy and axillary dissection were performed, and the final diagnosis was consistent with metaplastic spindle cell carcinoma. Conclusion: Spindle cell carcinoma of the breast is a rare aggressive histological type of carcinoma which may present with benign features on imaging. Tissue diagnosis is essential for prompt diagnosis with multidisciplinary team discussion to guide management and improve patient’s outcome.

Tubular Carcinoma of the Breast: Further Evidence to Support Its Excellent Prognosis

2010 ◽  
Vol 28 (1) ◽  
pp. 99-104 ◽  
Author(s):  
Emad A. Rakha ◽  
Andrew H.S. Lee ◽  
Andrew J. Evans ◽  
Sindhu Menon ◽  
Nancy Y. Assad ◽  
...  
Keyword(s):  
Ductal Carcinoma ◽  
Disease Free Survival ◽  
Distinct Type ◽  
Second Primary ◽  
Low Grade ◽  
Breast Cancers ◽  
Luminal A ◽  
Cancer Specific Survival ◽  
Tubular Carcinoma ◽  
Molecular Features

Purpose Although tubular carcinoma (TC) is known to have a favorable prognosis, it is still unknown whether this subtype represents a distinct type of breast carcinoma or whether it behaves like other low-grade luminal A–type breast carcinomas. Methods In this study, we performed a retrospective analysis of a large well-characterized series of breast cancers (2,608 carcinomas) to assess the clinicopathologic and molecular features and prognostic value of TC compared with grade 1 ductal carcinomas of the breast. Results When compared with grade 1 ductal carcinoma (n = 212), TC (n = 102) was more likely to be detected on mammographic screening, had smaller median size, and less frequently showed lymphovascular invasion. Compared with grade 1 ductal carcinoma, TC was associated with longer disease-free survival (χ2 = 13.25, P < .001) and breast cancer–specific survival (χ2 = 8.8, P = .003). In this study, none of the patients with TC developed distant metastasis or died from the disease without an intervening recurrence as invasive carcinoma of different histologic type. Conclusion We conclude that the biologic behavior of TC is excellent and is more favorable than that of grade 1 ductal carcinoma. Patients with TC may be at risk of developing second primary carcinomas in the contralateral breast, which may be of higher grade and poorer potential prognostic outcome. In addition, patients with TC seem to have a close to normal life expectancy, and as a consequence, adjuvant systemic therapy may not be justified in their routine management.

scholarly journals Evaluation of BRCA1-related molecular features and microRNAs as prognostic factors for triple negative breast cancers

BMC Cancer ◽  
2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Meriem Boukerroucha ◽  
Claire Josse ◽  
Sonia ElGuendi ◽  
Bouchra Boujemla ◽  
Pierre Frères ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Triple Negative ◽  
Breast Cancers ◽  
Molecular Features

Molecular profiling of triple-negative endometrial cancers (TNEC) and triple-negative breast cancers (TNBC) to reveal unique expression profiles.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 159-159
Author(s):  
Nathaniel L. Jones ◽  
Joanne Xiu ◽  
Sandeep K. Reddy ◽  
Jason Dennis Wright ◽  
William M. Burke ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endometrial Cancer ◽  
Protein Expression ◽  
Triple Negative ◽  
Expression Profiles ◽  
Receptor Expression ◽  
Mutation Rates ◽  
Breast Cancers ◽  
Her2 Receptor ◽  
Molecular Features

159 Background: “Triple negative” has been used to characterize a subtype of breast cancer that lacks estrogen, progesterone, and HER2 receptor expression. They are aggressive cancers with limited treatment options. It’s unknown if similar phenotype found in other cancer types, like endometrial cancer, harbor similar molecular alterations and prognosis. We aim to compare molecular features between TNEC and TNBC. Methods: A total of 3133 endometrial cancer samples were evaluated by Caris Life Sciences (Phoenix, AZ) from Mar, 2011 to Jul, 2014 by multiplatform profiling, which included a combination of sequencing (Sanger or NGS), protein expression (IHC), and/or gene amplification (CISH or FISH). 545 TNEC and 2049 TNBC were identified based on reported pathology and compared using Fisher exact tests. Results: Compared to an incidence of 15-20% TNBC in breast cancer, 17% (545/3133) TNEC was seen in our cohort, of which 13% were endometrioid, 22% serous, 26% carcinosarcoma, 7% clear cell, and 22% other. Compared with TNBC, TNEC showed 1.9 exonic mutations per case while TNBC showed 1.2 mutations per case. As shown in the table, AR expression is lower in TNEC than TNBC. TP53 mutation was common in both but more frequent in TNBC. While BRCA1/2 mutation rates were similar, low MGMT and ERCC1 were more common in TNEC, suggesting increased aberrant DNA repair. DNA synthesis protein expression was higher in TNEC including TS, RRM1, and TOPO2A, although TNBC had higher TOPO1. PD-1 expression was more common in TNEC suggesting immune pathway involvement. PI3K/AKT/mTor, MAPK and Wnt pathways were more involved in TNEC with greater PTEN, PIK3CA, FBXW7, KRAS and CTNNB1 mutations. Conclusions: Our study reveals significantly higher overall mutation rates in TNEC than TNBC, and specifically higher activations of multiple molecular pathways including PI3K/Akt/mTor, MAPK and Wnt. Further studies are warranted to validate these findings in clinical trials.

scholarly journals Clinicopathological Examination of Metaplastic Spindle Cell Carcinoma of the Breast: Case Series

2021 ◽  
Vol 15 ◽  
pp. 117822342110394
Author(s):  
Yumiko Ishizuka ◽  
Yoshiya Horimoto ◽  
Naotake Yanagisawa ◽  
Atsushi Arakawa ◽  
Katsuya Nakai ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Triple Negative ◽  
Spindle Cell ◽  
Case Series ◽  
Spindle Cell Carcinoma ◽  
Metaplastic Carcinoma ◽  
Programmed Death ◽  
Significant Difference ◽  
Cell Components ◽  
The Mean

Background: Spindle cell carcinoma (SpCC) of the breast is a rare histological type, a subtype of metaplastic carcinoma characterized by atypical spindle cell and epithelial carcinoma. The proportions of the spindle cell and epithelial components vary among tumours. Due to its rarity, biological characteristics of this disease have been poorly studied. Methods: In total, 10 patients with SpCC were surgically treated at our institution from January 2007 to December 2018. We retrospectively investigated these SpCC cases, focusing on the differences between spindle cell and epithelial components. Microsatellite status was also examined. Results: Nine cases were triple-negative breast cancer (TNBC). The rates of high tumour grade were 70% in spindle cell components and 56% in epithelial components ( P = .65), while the mean Ki67 labelling index were 63% and 58%, respectively ( P = .71). Mean programmed death ligand 1 (PD-L1) expression in these components was 11% and 1%, respectively ( P = .20). All 10 tumours were microsatellite stable. Patient outcomes of triple-negative SpCC did not differ from those of propensity-matched patients with conventional TNBC. Conclusions: Spindle cell components showed higher values in factors examined, although there was no statistically significant difference. Our data reveal that these 2 components of SpCC may be of different biological nature.

scholarly journals Immune-related biomarkers in triple-negative breast cancer

Breast Cancer ◽  
2021 ◽  
Author(s):  
Juan Zhang ◽  
Qi Tian ◽  
Mi Zhang ◽  
Hui Wang ◽  
Lei Wu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Combined Treatment ◽  
Tumor Infiltrating Lymphocytes ◽  
Molecular Characteristics ◽  
Immune Gene ◽  
Breast Cancers ◽  
Related Factors ◽  
Molecular Features

AbstractBreast cancer is a commonly diagnosed female cancer in the world. Triple-negative breast cancer (TNBC) is the most dangerous and biologically aggressive subtype in breast cancer which has a high mortality, high rates of relapse and poor prognosis, representing approximately 15–20% of breast cancers. TNBC has unique and special biological molecular characteristics and higher immunogenicity than other breast cancer types. On the basis of molecular features, TNBC is divided into different subtypes and gets various treatments. Especially, immunotherapy becomes a promising and effective treatment to TNBC. However, not all of the TNBC patients are sensitive to immunotherapy, the need of selecting the patients suitable for immunotherapy is imperative. In this review, we discussed recent discoveries about the immune-related factors of TNBC, including tumor-infiltrating lymphocytes (TILs), programmed death-ligand protein-1 (PD-L1), immune gene signatures, some other emerging biomarkers for immunotherapy effectivity and promising biomarkers for immunotherapy resistance. In addition, we summarized the features of these biomarkers contributing to predict the prognosis and effect of immunotherapy. We hope we can provide some helps or evidences to clinical immunotherapy and combined treatment for TNBC patients.

Association of pathological complete response rates and TILs in triple-negative breast cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12596-e12596
Author(s):  
Mahmoud Kassem ◽  
Daniel Goldstein ◽  
Patrick Schnell ◽  
Michael Grimm ◽  
Dionisia Marie Quiroga ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Working Group ◽  
Triple Negative ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Comprehensive Cancer Center ◽  
Breast Cancers ◽  
Long Term Prognosis ◽  
Response To Neoadjuvant Chemotherapy

e12596 Background: Triple negative breast cancers (TNBC), characterized by the lack of expression of estrogen receptors and progesterone receptors as well as human epidermal growth factor receptor 2, are associated with high distant recurrence rate and death. As a result, the majority of patients with TNBC are treated with perioperative chemotherapy with the goal of eradicating micrometastases and preventing distrant relapse. The preoperative systemic therapy offers the advantages of permitting an assessment of chemo-sensitivity, increased rates of breast conserving surgery and the ability to adapt postoperative therapies depending on the response. Recently, neoadjuvant chemotherapy has been used at an increasing frequency. The response to neoadjuvant chemotherapy, as measured by the residual cancer burden index, for example, is correlated with the long-term prognosis of TNBC and HER2 expressing breast cancers. Previous studies suggest that tumor-infiltrating lymphocytes (TILs) may correlate with pathological complete response (pCR) rates in TNBC patients treated with neoadjuvant chemotherapy. The pathologic evaluation of TILs in TNBC has been recommended by the International TILs working group since 2014. In this study we sought to analyze the association of TILs with pCR in a cohort of TNBC patients treated with neoadjuvant chemotherapy. Methods: An IRB-approved single-institution retrospective analysis was performed on 127 patients diagnosed with TNBC who received neoadjuvant anthracycline and taxane based chemotherapy at the Ohio State University Comprehensive Cancer Center between January 1st, 2012 and November 31st, 2018. We analyzed TILs as a continuous variable as a part of a secondary analysis of this data. Whole tissue sections from archived H&E stained glass slides were scanned using Philips UltraFast Scanner at ×40 magnification with a single-focus layer. TIL scoring was performed according to guideline recommendations from the International TILs Working Group (2014). Results: A total of 127 female patients with TNBC were identified. The median age at diagnosis was 52.0 years (range 32.0, 74.0) and patients were predominately white (103, 81%), post-menopausal (68, 53.5%) and presented with invasive ductal cancer (113, 89%), stage II (88, 69%), and high grade (108, 85%). Of those patients, 56 had TILs measurement available. pCR was associated with statistically higher level of TILs in core biopsies taken prior to chemotherapy had (Wilcoxon rank-sum test, p = 0.04). Conclusions: The long-term prognosis of patients with TNBC is predicted by the response to neoadjuvant chemotherapy. Consistent with other studies, our study revealed that TILs are associated with a higher probability of pCR. Our future goals are to identify which TIL subsets correlate best with pCR and to identify the mechanism for the increased chemotherapy responsiveness of lymphocyte-infiltrated tumors.

scholarly journals Differences in molecular features of triple‐negative breast cancers based on the age at diagnosis

Cancer ◽  
2018 ◽  
Vol 124 (24) ◽  
pp. 4676-4684 ◽  
Author(s):  
H. Evin Gulbahce ◽  
Philip S. Bernard ◽  
Erin K. Weltzien ◽  
Rachel E. Factor ◽  
Lawrence H. Kushi ◽  
...  
Keyword(s):  
Triple Negative ◽  
Age At Diagnosis ◽  
Breast Cancers ◽  
Molecular Features

scholarly journals Glycogen Rich Clear Cell Carcinoma Pada Payudara

2019 ◽  
Vol 6 (2) ◽  
pp. 146-149
Author(s):  
Finot Finot ◽  
Dik Puspasari ◽  
Siti Amarwati
Keyword(s):  
Breast Carcinoma ◽  
Cell Carcinoma ◽  
Tumor Cells ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Periodic Acid ◽  
Low Grade ◽  
Breast Cancers ◽  
Signet Ring ◽  
Pas Staining

Background: Glycogen rich clear cell carcinoma is a rare neoplasm of the breast, with the incidence of 1.4-3% of all breast cancers. The tumour has distinct morphology, different from that of common breast cancers. Glycogen rich clear cell carcinomas are members of a heterogeneous group of neoplasms, including signet-ring, secretory and lipid-rich carcinomas of the breast. In general, clear cell breast carcinoma tends to follow an aggressive clinical course. Case report: To present a case of a 47 years old woman suffering from breast mass in the upper outer quadrant of her right breast. On macroscopic examination, the biopsy tumor sized 2x1.5x0.5 cm and solid with brown and white. Discussion: Microscopic examination showed breast tissue composed of tumor cells arranged in nets, trabeculae and singly dispersed. Tumor cells are moderately pleomorphic, have sharply defined border and polygonal contours. Cytoplasm is clear in more than 90% of cells and finely granular in few cells. Nuclei are hyperchromatic with clumped chromatin and prominent nucleoli. Occasional mitosis is also observed. Special stain (PAS Staining): Intracytoplasmic PAS positivity in tumor cells are variable. Immunohistochemistry ER (+) positive >20-50%, PR (+) positive <20%, HER2 (-) negative. The patient was diagnosed with glycogen rich clear cell carcinoma. Conclusion: Glycogen rich clear cell carcinoma of the breast is rare. Its clinical feature is rather aggressive and varies depending on special characteristics such as low grade. Keywords: Glycogen rich clear cell carcinoma, breast carcinoma, PAS staining   Latar belakang: Glycogen rich clear cell carcinoma adalah kanker payudara yang jarang, dengan insidensi 1.4-3% dari semua kanker payudara. Tumor memiliki morfologi yang berbeda dari kanker payudara pada umunya. Glycogen rich clear cell carcinoma merupakan neoplasma heterogen yang termasuk karsinoma payudara signet-ring, sekretori dan kaya lipid. Secara umum, carcinoma ini cenderung mengikuti perjalanan klinis yang agresif. Tujuan: Laporan Kasus: Dilakukan pemeriksaan makroskopis jaringan tumor dari seorang perempuan berusia 47 tahun dengan massa payudara kanan di kuadran luar atas. Tumor biopsi berukuran 2x1.5x0.5 cm, komposisi padat, berwarna coklat dan putih. Dilakukan pemeriksaan histopatologi, imunohistokimia dan histokimia pewarnaan khusus PAS (Periodic Acid Schiff). Pembahasan: Pemeriksaan mikroskopis menunjukkan jaringan payudara dengan sel-sel tumor yang tersusun dalam jaring, trabekula dan tersebar tunggal. Sel-sel tumor cukup pleomorfik, hiperkromatik, kromatin kasar dan nucleoli prominent, mitosis dapat ditemukan, sitoplasma jernih lebih dari 90% sel dan granular halus dalam beberapa sel, memiliki garis batas dan beberapa bentuk poligon yang jelas. Hasil histokimia PAS (+) positif, Immunohistokimia ER (+) positif > 20-50% pada sel-sel tumor, PR (+) positif < 20%, HER2 (-) negatif. Dari hasil pemeriksaan tersebut, pasien didiagnosis Glycogen rich clear cell carcinoma. Kesimpulan: Glycogen rich clear cell carcinoma pada payudara adalah tumor yang jarang, perilaku klinisnya dilaporkan agak agresif sejauh ini, sangat bervariasi tergantung pada karakteristik khusus seperti tingkat rendah. Kata kunci: Glycogen rich clear cell carcinoma, karsinoma payudara, pewarnaan PAS.

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