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. 2010 Sep 23:10:507.
doi: 10.1186/1471-2407-10-507.

Triple-negative, basal-like, and quintuple-negative breast cancers: better prediction model for survival

Yoon-La Choi  1 , Ensel Oh, Sarah Park, Yeonju Kim, Yeon-Hee Park, Kyoung Song, Eun Yoon Cho, Yun-Chul Hong, Jong Sun Choi, Jeong Eon Lee, Jung Han Kim, Seok Jin Nam, Young-Hyuck Im, Jung-Hyun Yang, Young Kee Shin
Affiliations

Triple-negative, basal-like, and quintuple-negative breast cancers: better prediction model for survival

Yoon-La Choi et al. BMC Cancer. .

Erratum in

  • BMC Cancer. 2011;11:13

Abstract

Background: Triple-negative breast cancers (TNBCs) and basal-like breast cancers (BLBCs) are known as poor outcome subtypes with a lack of targeted therapy. Previous studies have shown conflicting results regarding the difference of prognostic significance between TNBCs and BLBCs. In this study, we aimed to characterize the prognostic features of TNBCs, in view of BLBCs and quintuple-negative breast cancers (QNBC/5NPs).

Methods: Using tissue microarray-based immunohistochemical analysis, we categorized 951 primary breast cancers into four or five subtypes according to the expression of ER, PR, HER2, and basal markers (CK5/6, EGFR).

Results: The results of this study showed that both TNBCs and BLBCs were associated with high histological and/or nuclear grades. When the TNBCs are divided into two subtypes by the presence of basal markers, the clinicopathologic characteristics of TNBCs were mainly maintained in the BLBCs. The 5-subgrouping was the better prediction model for both disease free and overall survival in breast cancers than the 4-subgrouping. After multivariate analysis of TNBCs, the BLBCs did not have a worse prognosis than the QNBC/5NPs. Interestingly, the patients with BLBCs showed significant adjuvant chemotherapy benefit. In addition, QNBC/5NPs comprised about 6~8% of breast cancers in publicly available breast cancer datasets

Conclusion: The QNBC/5NP subtype is a worse prognostic subgroup of TNBCs, especially in higher stage and this result may be related to adjuvant chemotherapy benefit of BLBCs, calling for caution in the identification of subgroups of patients for therapeutic classification.

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Figures

Figure 1
Figure 1
Kaplan-Meier curves of disease-free survival and overall survival. Disease-free survival according to (A) four and (C) five IHC-based subtypes of breast cancers in the study subjects. Overall survival according to (B) four and (D) five subtypes of breast cancers in the study subjects (Estimated mean survival with 95% CI).
Figure 2
Figure 2
Association between chemotherapy and four-subtypes of breast cancers. Kaplan-Meier curves of disease-free survival (A and C) and overall survival (B and D). Cases without chemotherapy (A and B) and with chemotherapy (C and D) (Estimated mean survival with 95% CI). *P < 0.001, **P = 0.027
Figure 3
Figure 3
Association between chemotherapy and five-subtypes of breast cancers. Kaplan-Meier curves of disease-free survival (A and C) and overall survival (B and D). Cases without chemotherapy (A and B) and with chemotherapy (C and D) (Estimated mean survival with 95% CI). *P = 0.001, **P < 0.001
Figure 4
Figure 4
Comparison of the expression levels of five genes according to five subtypes in the microarray data sets. (A) Proportion of five breast cancer subtypes in two large-sized microarray data sets. (B) Expression levels of the five markers according to the subtypes in Vijver et al. (C) Expression levels of the five markers according to the subtypes in Wang et al. Distribution of expression levels of each marker was described with box plots. The bottom and top of the box are the 25th and 75th percentile, and the band near the middle of the box is the 50th percentile.
See this image and copyright information in PMC

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