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Observational Study
. 2020 Jun 2;20(1):491.
doi: 10.1186/s12885-020-06998-9.

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

Francesca Sanges  1 , Matteo Floris  1   2 , Paolo Cossu-Rocca  3   4 , Maria R Muroni  5 , Giovanna Pira  1 , Silvana Anna Maria Urru  2   6 , Renata Barrocu  1 , Silvano Gallus  7 , Cristina Bosetti  8 , Maurizio D'Incalci  8 , Alessandra Manca  9 , Maria Gabriela Uras  5 , Ricardo Medda  2 , Elisabetta Sollai  10 , Alma Murgia  10 , Dolores Palmas  11 , Francesco Atzori  12 , Angelo Zinellu  1 , Francesca Cambosu  1 , Tiziana Moi  10 , Massimo Ghiani  11 , Vincenzo Marras  9 , Maria Cristina Santona  13 , Luisa Canu  13 , Enrichetta Valle  11 , Maria Giuseppina Sarobba  14 , Daniela Onnis  15 , Anna Asunis  15 , Sergio Cossu  13 , Sandra Orrù  10 , Maria Rosaria De Miglio  16
Affiliations
Observational Study

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

Francesca Sanges et al. BMC Cancer. .

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.

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

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curves of disease free survival (a) and overall survival (b) of patients affected by “Triple Negative” breast cancer according to histologic types
See this image and copyright information in PMC

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