A clinicopathological study of triple-negative breast carcinoma in a patient cohort from a tertiary care center in Sri Lanka.


Journal

Indian journal of pathology & microbiology
ISSN: 0974-5130
Titre abrégé: Indian J Pathol Microbiol
Pays: India
ID NLM: 7605904

Informations de publication

Date de publication:
Historique:
entrez: 10 8 2020
pubmed: 10 8 2020
medline: 8 6 2021
Statut: ppublish

Résumé

Triple negative breast carcinoma (TNBC) and basal-like breast carcinoma (BLBC) are subtypes of breast carcinoma (BCa) that are associated with poor survival. To study the prevalence, clinicopathological profile and survival of TNBC among a Sri Lankan patient cohort and to determine the proportion and predictive histological features of BLBC among TNBCs. A cohort of 221 women undergoing primary surgery for BCa at a tertiary-care center in Sri Lanka was studied. Clinicopathological and follow-up information were collected by patient interviews and review of slides and clinical records. Estrogen, progesterone, HER2 receptors, and basal markers (CK5/6, CK14, EGFR, 34βE12) were evaluated immunohistochemically. Data was analyzed with Chi-square test, multinomial logistic regression, and Cox regression using SPSS20.0. Fifty-three (24%) tumors were triple-negative (95%CI = 18.37%-29.63%). On multivariate analysis, young age (P = 0.002), high Nottingham grade (P = 0.005), moderate to severe tumor necrosis (P = 0.004), absent ductal carcinoma in situ (DCIS) (P = 0.04), reduced vascular density at tumor edge (P = 0.016) and distinct cell margins (P = 0.047) predicted TNBC over luminal subgroups, whereas reduced vascular density (P = 0.004) and low TNM stage (P = 0.011) distinguished TNBC and HER2. BLBC accounted for 45.28% (95%CI 32.66%-58.55%-24/53) of TNBC. The presence of extensive necrosis in TNBC correlated significantly with BLBC (P = 0.03). The survival among the TNBC subgroup did not differ significantly from other subgroups. Twenty four percent were TNBCs by immunohistochemical analysis, comparable to studies in the Indian subcontinent, however higher than the West. TNBC status correlated with younger age, high tumor grade, necrosis, absent DCIS, reduced vascular density at tumor edge, and distinct cell margins. The presence of moderate to extensive necrosis in TNBC was predictive of BLBC.

Sections du résumé

BACKGROUND BACKGROUND
Triple negative breast carcinoma (TNBC) and basal-like breast carcinoma (BLBC) are subtypes of breast carcinoma (BCa) that are associated with poor survival.
AIMS OBJECTIVE
To study the prevalence, clinicopathological profile and survival of TNBC among a Sri Lankan patient cohort and to determine the proportion and predictive histological features of BLBC among TNBCs.
STUDY SETTING AND DESIGN METHODS
A cohort of 221 women undergoing primary surgery for BCa at a tertiary-care center in Sri Lanka was studied.
MATERIALS AND METHODS METHODS
Clinicopathological and follow-up information were collected by patient interviews and review of slides and clinical records. Estrogen, progesterone, HER2 receptors, and basal markers (CK5/6, CK14, EGFR, 34βE12) were evaluated immunohistochemically.
STATISTICAL ANALYSIS METHODS
Data was analyzed with Chi-square test, multinomial logistic regression, and Cox regression using SPSS20.0.
RESULTS RESULTS
Fifty-three (24%) tumors were triple-negative (95%CI = 18.37%-29.63%). On multivariate analysis, young age (P = 0.002), high Nottingham grade (P = 0.005), moderate to severe tumor necrosis (P = 0.004), absent ductal carcinoma in situ (DCIS) (P = 0.04), reduced vascular density at tumor edge (P = 0.016) and distinct cell margins (P = 0.047) predicted TNBC over luminal subgroups, whereas reduced vascular density (P = 0.004) and low TNM stage (P = 0.011) distinguished TNBC and HER2. BLBC accounted for 45.28% (95%CI 32.66%-58.55%-24/53) of TNBC. The presence of extensive necrosis in TNBC correlated significantly with BLBC (P = 0.03). The survival among the TNBC subgroup did not differ significantly from other subgroups.
CONCLUSION CONCLUSIONS
Twenty four percent were TNBCs by immunohistochemical analysis, comparable to studies in the Indian subcontinent, however higher than the West. TNBC status correlated with younger age, high tumor grade, necrosis, absent DCIS, reduced vascular density at tumor edge, and distinct cell margins. The presence of moderate to extensive necrosis in TNBC was predictive of BLBC.

Identifiants

pubmed: 32769327
pii: IndianJPatholMicrobiol_2020_63_3_388_291683
doi: 10.4103/IJPM.IJPM_657_19
doi:

Substances chimiques

Biomarkers, Tumor 0
Receptors, Estrogen 0
Receptors, Progesterone 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

388-396

Auteurs

Harshima D Wijesinghe (HD)

Department of Pathology, Faculty of Medicine, University of Colombo, Sri Lanka.

Janakie Fernando (J)

Department of Pathology, National Hospital of Sri Lanka, Sri Lanka.

Upul Senarath (U)

Department of Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka.

Gayani K Wijesinghe (GK)

Department of Pathology, Faculty of Medicine, University of Colombo, Sri Lanka.

Menaka D S Lokuhetty (MD)

Department of Pathology, Faculty of Medicine, University of Colombo, Sri Lanka.

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Classifications MeSH