Original Article

Breast Cancer

, Volume 17, Issue 2, pp 118-124

Clinicopathological analyses of triple negative breast cancer using surveillance data from the Registration Committee of the Japanese Breast Cancer Society

  • Hirotaka IwaseAffiliated withMember of the Research Group, Japanese Breast Cancer SocietyDepartment of Breast and Endocrine Surgery, Kumamoto University Email author 
  • , Junichi KurebayashiAffiliated withMember of the Research Group, Japanese Breast Cancer SocietyDepartment of Breast and Thyroid Surgery, Kawasaki Medical University
  • , Hitoshi TsudaAffiliated withMember of the Research Group, Japanese Breast Cancer SocietyPathology Section, Clinical Laboratory Division, National Cancer Center Hospital
  • , Tomohiko OhtaAffiliated withMember of the Research Group, Japanese Breast Cancer SocietyDivision of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine
  • , Masafumi KurosumiAffiliated withMember of the Research Group, Japanese Breast Cancer SocietyDepartment of Pathology, Saitama Prefecture Cancer Center
  • , Kazuaki MiyamotoAffiliated withMember of the Research Group, Japanese Breast Cancer SocietyDepartment of Surgery, National Hospital Organization Kure Medical Center/Chugoku Cancer Center
  • , Yutaka YamamotoAffiliated withDepartment of Breast and Endocrine Surgery, Kumamoto University
  • , Takuji IwaseAffiliated withDirector of the Registration Committee of the Japanese Breast Cancer SocietyDepartment of Breast Clinic, Cancer Institute Ariake Hospital

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Abstract

Background

Triple negative (TN) breast cancer is defined as a subtype that is negative for estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2). To clarify the characteristics of TN breast cancer, surveillance data of the Registration Committee of the Japanese Breast Cancer Society were analyzed.

Method

Of 14,748 cases registered in 2004, 11,705 (79.4%) were examined for ER, PgR, and HER2. Of these, the most prevalent (53.8%) was a hormone-responsive subtype with ER positive/PgR positive/HER2 negative, followed by TN subtype (15.5%).

Results

The proportion of postmenopausal patients was relatively high in the TN subtype. This cancer was diagnosed at a slightly advanced stage and with more cases positive for lymph node metastases than other subtypes. Morphologically, the TN subtype was more frequently classified as solid-tubular carcinoma. Mucinous, tubular, or secretary carcinomas were frequently found in the hormone receptor positive/HER2 negative subtype, while squamous cell carcinoma, spindle cell carcinoma, and metaplastic carcinoma with bone/cartilage metaplasia were very frequently found in the TN group. Apocrine carcinoma was also found very frequently in the TN group. Selection of chemotherapy was not based on receptor subtypes, but was determined by the degree of tumor progression.

Conclusions

Although TN types are similar to basal-like breast tumor, as determined by gene profiling, their diagnosis needs verification by determination of the level of epidermal growth factor receptor or cytokeratin 5/6 expression. TN type should be examined further for immunohistochemical features and analyzed for prognostic details in this cohort.

Keywords

Triple negative tumor Breast cancer Surveillance data