Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis

BMC Cancer

Ricardo Medda¹  Silvana Anna Maria Urru¹  Francesca Sanges²  Francesca Cambosu²  Giovanna Pira²  Renata Barrocu²  Angelo Zinellu²  Matteo Floris²  Silvano Gallus³  Maria Giuseppina Sarobba⁴  Enrichetta Valle⁵  Dolores Palmas⁵  Massimo Ghiani⁵  Maria Rosaria De Miglio⁶  Maria R. Muroni⁶  Maria Gabriela Uras⁶  Paolo Cossu-Rocca⁶  Cristina Bosetti⁷  Maurizio D’Incalci⁷  Vincenzo Marras⁸  Alessandra Manca⁸  Luisa Canu⁹  Maria Cristina Santona⁹  Sergio Cossu⁹  Anna Asunis^1,10  Daniela Onnis^1,10  Alma Murgia^1,11  Tiziana Moi^1,11  Sandra Orrù^1,11  Elisabetta Sollai^1,11  Francesco Atzori^1,12 

[1] Biomedicine Sector, Center for Advanced Studies, Research and Development in Sardinia Technology Park Polaris;Department of Biomedical Sciences, University of Sassari;Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS;Department of Medical Oncology, ASSL Nuoro;Department of Medical Oncology, “A. Businco” Oncologic Hospital, ASL Cagliari;Department of Medical, Surgical and Experimental Sciences, University of Sassari;Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS;Department of Pathology, AOU Sassari;Department of Pathology, ASSL Nuoro;Department of Pathology, Brotzu Hospital;Department of Pathology, “A. Businco” Oncologic Hospital, ASL Cagliari;Medical Oncology Unit, AOU;

关键词: Triple negative breast cancer;    Clinico-pathological features;    Prognosis;    Histologic special type;    Tumor size;    Metastatic lymph node;   

DOI  :  10.1186/s12885-020-06998-9

来源: DOAJ

【 摘 要 】

Abstract Background Triple Negative breast cancer (TNBC) includes a heterogeneous group of tumors with different clinico-pathological features, molecular alterations and treatment responsivity. Our aim was to evaluate the clinico-pathological heterogeneity and prognostic significance of TNBC histologic variants, comparing “special types” to high-grade invasive breast carcinomas of no special type (IBC-NST). Methods This study was performed on data obtained from TNBC Database, including pathological features and clinical records of 1009 TNBCs patients diagnosed between 1994 and 2015 in the four most important Oncology Units located in different hospitals in Sardinia, Italy. Kaplan-Meier analysis, log-rank test and multivariate Cox proportional-hazards regression were applied for overall survival (OS) and disease free survival (DFS) according to TNBC histologic types. Results TNBC “special types” showed significant differences for several clinico-pathological features when compared to IBC-NST. We observed that in apocrine carcinomas as tumor size increased, the number of metastatic lymph nodes manifestly increased. Adenoid cystic carcinoma showed the smallest tumor size relative to IBC-NST. At five-year follow-up, OS was 92.1, 100.0, and 94.5% for patients with apocrine, adenoid cystic and medullary carcinoma, respectively; patients with lobular and metaplastic carcinoma showed the worst OS, with 79.7 and 84.3%, respectively. At ten-years, patients with adenoid cystic (100.0%) and medullary (94.5%) carcinoma showed a favourable prognosis, whereas patients with lobular carcinoma showed the worst prognosis (73.8%). TNBC medullary type was an independent prognostic factor for DFS compared to IBC-NST. Conclusions Our study confirms that an accurate and reliable histopathologic definition of TNBC subtypes has a significant clinical utility and is effective in the therapeutic decision-making process, with the aim to develop innovative and personalized treatments.

【 授权许可】

Unknown