Nottingham Prognostic Index in Triple-Negative Breast Cancer: a reliable prognostic tool?

BMC Cancer

Research Article

Vítor Carneiro¹  Jorge Cameselle-Teijeiro²  Isabel Amendoeira³  Daniella Vieira⁴  André Albergaria⁵  Fernanda Milanezi⁵  Fernando Schmitt⁶  Sara Ricardo⁷ 

[1] Department of Pathology of Hospital of Divino Espírito Santo, Ponta Delgada, Portugal;Department of Pathology, Hospital Xeral-Cíes, Vigo, Spain;Department of Pathology, Medical Faculty of University of Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal;Federal University of Santa Catarina, Florianopolis, Brazil;Institute of Molecular Pathology and Immunology of Porto University (IPATIMUP), Porto, Portugal;Institute of Molecular Pathology and Immunology of Porto University (IPATIMUP), Porto, Portugal;Department of Pathology, Medical Faculty of University of Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal;Institute of Molecular Pathology and Immunology of Porto University (IPATIMUP), Porto, Portugal;Institute of Biomedical Sciences of Abel Salazar (ICBAS), Porto, Portugal;

关键词: Breast Cancer;    Molecular Subtype;    Breast Cancer Subtype;    Nottingham Prognostic Index;    TNBC Patient;   

DOI  :  10.1186/1471-2407-11-299

 received in 2011-04-04, accepted in 2011-07-15,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundA breast cancer prognostic tool should ideally be applicable to all types of invasive breast lesions. A number of studies have shown histopathological grade to be an independent prognostic factor in breast cancer, adding prognostic power to nodal stage and tumour size. The Nottingham Prognostic Index has been shown to accurately predict patient outcome in stratified groups with a follow-up period of 15 years after primary diagnosis of breast cancer. Clinically, breast tumours that lack the expression of Oestrogen Receptor, Progesterone Receptor and Human Epidermal growth factor Receptor 2 (HER2) are identified as presenting a "triple-negative" phenotype or as triple-negative breast cancers. These poor outcome tumours represent an easily recognisable prognostic group of breast cancer with aggressive behaviour that currently lack the benefit of available systemic therapy. There are conflicting results on the prevalence of lymph node metastasis at the time of diagnosis in triple-negative breast cancer patients but it is currently accepted that triple-negative breast cancer does not metastasize to axillary nodes and bones as frequently as the non-triple-negative carcinomas, favouring instead, a preferentially haematogenous spread. Hypothetically, this particular tumour dissemination pattern would impair the reliability of using Nottingham Prognostic Index as a tool for triple-negative breast cancer prognostication.MethodsThe present study tested the effectiveness of the Nottingham Prognostic Index in stratifying breast cancer patients of different subtypes with special emphasis in a triple-negative breast cancer patient subset versus non- triple-negative breast cancer.ResultsWe demonstrated that besides the fact that TNBC disseminate to axillary lymph nodes as frequently as luminal or HER2 tumours, we also showed that TNBC are larger in size compared with other subtypes and almost all grade 3. Additionally, survival curves demonstrated that these prognostic factors are equally important to stratify different survival outcomes in non-TNBC as in TNBC. We also showed that the NPI retains the ability to stratify and predict survival of TNBC patients.ConclusionThe importance of this study relies on the need of prognostication improvements on TNBC, showing, at a clinical standpoint, that Nottingham Prognostic Index is as a truthful prognostic tool in TNBC.

【 授权许可】

Unknown   
© Albergaria et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.