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Triple-Negative/Basal-Like Breast Carcinomas

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A Comprehensive Guide to Core Needle Biopsies of the Breast

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Abstract

“Triple-negative” breast cancers (TNBC) account for 15–20% of breast cancers and are defined by the absence of hormone receptor protein expression by immunohistochemistry (IHC) and the absence of HER2 protein overexpression or gene amplification on IHC and in situ hybridization (ISH) studies, respectively. Histologically a majority of these tumors are characterized by a solid growth pattern with absent tubule formation, large pleomorphic nuclei, and a very brisk mitotic rate (i.e., a high combined histologic grade), limited or absent in situ component, zones of geographic necrosis, prominent lymphocytic infiltrate, central fibrotic focus or “acellular zone” and circumscribed or pushing (non-infiltrative) borders. Gene expression profiling studies have shown that, despite some heterogeneity, most TNBC are basal-like carcinomas (BLC). Patients with BLC/TNBC are more likely to be of younger age or premenopausal; and women of African American or West African ancestry or who are BRCA1 or BRCA2 mutation carriers have a greater likelihood of developing TNBC. BLC/TNBC do not respond to endocrine or HER2-targeted therapy and these tumors are associated with aggressive behavior, more frequent relapse and metastasis, and decreased overall survival. The development of tailored therapy for BLC/TNBC remains an area of active investigation.

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  1. Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA

    Yaileen D. Guzmán-Arocho & Laura C. Collins

  2. Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Benjamin C. Calhoun

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    Sandra J. Shin

  2. Department of Pathology, University of California San Francisco, San Francisco, CA, USA

    Yunn-Yi Chen

  3. Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA

    Paula S. Ginter

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Guzmán-Arocho, Y.D., Calhoun, B.C., Collins, L.C. (2022). Triple-Negative/Basal-Like Breast Carcinomas. In: Shin, S.J., Chen, YY., Ginter, P.S. (eds) A Comprehensive Guide to Core Needle Biopsies of the Breast . Springer, Cham. https://doi.org/10.1007/978-3-031-05532-4_11

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