Searching Inroads in Triple-Negative Breast Cancer
Journal Title: GUJARAT CANCER SOCIETY RESEARCH JOURNAL - Year 2014, Vol 16, Issue 2
Abstract
Triple-negative breast cancer (TNBC) is a unique type of breast cancer, which lacks the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) on the cell surface. Current literature reveals that TNBC itself is not a single disease and it has many molecular subtypes with variable prognosis. It is akin to non Hodgkin’s lymphoma, which also bears a negative terminology; likewise TNBC includes different sub entities. There are two broad subtypes of TNBC (basal like and non-basal like) defined either by gene expression profiling or by immunohistochemistry (IHC) markers. Basal like TNBC express basal markers like CK5/6, CK14, CK17 and epithelial growth factor receptor (EGFR). Consistent with its more aggressive biology this BC subtype very often manifests itself as an interval cancer diagnosed between screening mammograms. More than 90% of BLBCs/TNBCs exhibit an invasive ductal histology and high histological grade. Anthracycline and taxane based chemotherapy is still standard of care however limited data are available for its impact on overall outcome of TNBC. Dose dense chemotherapy has been tried and it improves pathological complete remission (CR) but whether it translates into survival advantage is still controversial. Platinum compounds have theoretical advantage of being more effective in TNBC however clinical data regarding optimal use of platinum compounds in TNBC is still lacking. The majority of studies indicate a negative impact of a triple negative (TN) or basal like (BL) phenotype on patient prognosis. Peak risk of recurrence occurs within the first 3 years after initial treatment of the disease with the majority of deaths occurring in the first 5 years, and after diagnosis of metastatic disease, a significantly shorter survival was observed in both BL and TNBC. Till date, there are many unresolved issues related to prognosis and therapeutics of TNBC which need to be addressed.
Authors and Affiliations
Sonia Parikh, Shilin Shukla, shailesh Talati
Keywords
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