Breast Cancer Research and Treatment

, Volume 111, Issue 3, pp 569–570

ERCC1 expression in triple negative breast carcinoma: the paradox revisited


    • Institute of Pathologic Anatomy and Histology, Division of Cancer Research University of Perugia
  • Fabio Cartaginese
    • Institute of Pathologic Anatomy and Histology, Division of Cancer Research University of Perugia
  • Mariantonietta Colozza
    • Medical Oncology DivisionAzienda Ospedaliera
  • Stefania Gori
    • Medical Oncology DivisionAzienda Ospedaliera
  • Lucio Crinó
    • Medical Oncology DivisionAzienda Ospedaliera
Letter to the editor

DOI: 10.1007/s10549-007-9804-4

Cite this article as:
Sidoni, A., Cartaginese, F., Colozza, M. et al. Breast Cancer Res Treat (2008) 111: 569. doi:10.1007/s10549-007-9804-4

Dear Editor, The so-called Triple Negative (TN) subtype of infiltrating carcinoma of the breast accounts for about 15% of all breast cancers [14].

To date it is not clear if the TN category corresponds completely to the basal-like group [3]. However, patients with TN carcinomas are clinically relevant because the clinical behaviour is more aggressive [1] and since chemotherapy is the only treatment available due to lack of specific molecular targets [5].

This latter aspect has been called “the triple negative paradox” [6] based on an apparent better response to chemotherapeutics.

The study by Tan et al. [7] published in your Journal, conducted on a large series of TN breast carcinomas, gives a poor clinical outcome after anthracycline treatment.

The Authors claim that TN do not correspond precisely to the basal-like category however, triple negativity remains an adverse prognostic marker for which alternative first-line chemotherapeutic regimens are required.

A suitable option for patients with TN tumours may be a platinum-based therapy. A previous study conducted on non small cell lung cancers demonstrated that a common cause of cisplatin resistance may be related to ERCC1 (excision repair cross-complementation group 1) expression [8].

In view of a possible use of platinum-based therapy in TN breast cancer we decided to examine the ERCC1 expression in a group of 81 carcinomas with 0% expression of ER, PR and HER-2.

Tumor sections were immunostained using a monoclonal antibody (ERCC1, clone 8F1, dilution 1:100, Neomarkers, Fremont, CA, USA). Slides were evaluated by a semiquantitative scoring system [9] obtained multiplying the percentage of positive nuclei with the intensity of staining. There were 26 (32%) positive cases with a score ≥1 (Fig. 1). No significant correlation with the main clinicopathological features were observed.
Fig. 1

Immunocytochemical demonstration of ERCC1 in a triple negative invasive breast carcinoma with expression score 2. (200×)

Our results demonstrate that about one third of the TN breast cancers harbour a relevant expression of ERCC1 that may be predictive of a poor response to platinum-based chemotherapies.

Therefore, we suggest that the immunohistochemical screening for ERCC1 in TN breast cancers could be a useful tool for a better identification of patients who may benefit from platinum-containing treatments.

Copyright information

© Springer Science+Business Media, LLC. 2007