Breast Cancer Research and Treatment

, Volume 111, Issue 3, pp 405–410

Mammographic features of triple receptor-negative primary breast cancers in young premenopausal women

  • Wei-Tse Yang
  • Mark Dryden
  • Kristine Broglio
  • Michael Gilcrease
  • Shaheenah Dawood
  • Peter J. Dempsey
  • Vicente Valero
  • Gabriel Hortobagyi
  • Deann Atchley
  • Banu Arun
Review

Abstract

Background The mammographic features of triple receptor-negative [TRN] breast cancers, a distinct cancer subtype with a poor prognosis have not been reported to our knowledge. The aim of this study was to compare the mammographic breast density, visibility, and tumor features of different breast cancer immunophenotypes. Patients and methods We identified all premenopausal women aged 45 years or less who had been diagnosed with primary breast cancer between January 1999 and November 2005 at a single institution and who had undergone mammography at initial diagnosis. Patient characteristics including clinical, histologic, and mammographic features of breast cancers were tabulated by immunophenotype and compared with the chi-square test or the Kruskal–Wallis test. The P values less than 0.05 were considered statistically significant. Results We identified 198 premenopausal women who had been diagnosed with breast cancer. Thirty-eight (19%) women had TRN cancer, 67 (34%) had HER2+ cancer, and 93 (47%) had ER+ cancer. Mammographic density and cancer visibility were similar between all immunophenotypes of cancers. TRN cancers were more frequently associated with a mass (33/33 [100%]) than were HER2+ (35/64 [55%]) and ER+ cancers (42/87 [48%]) (P < 0.0001), and were less frequently associated with calcifications (5/33 [15%]) than were HER2+ (43/64 [67%]) and ER+ (53/87 [61%]) cancers (P < 0.0001). Associated ductal carcinoma in situ was reported in 18% (7/38), 57% (38/67), and 48% (52/93) of TRN, HER2+, and ER+ patients, respectively (P = 0.0003). Conclusion The mammographic features of TRN breast cancer suggest more rapid carcinogenesis leading directly to invasive cancer, that may require adjunct imaging tools for early diagnosis.

Keywords

Mammography Triple receptor-negative Breast cancer Breast density Microcalcifications 

References

  1. 1.
    Perou CM, Jeffrey SS, van de Rijn M et al (1999) Distinctive gene expression patterns in human mammary epithelial cells and breast cancers. Proc Natl Acad Sci USA 96:9212–9217PubMedCrossRefGoogle Scholar
  2. 2.
    Perou CM, Sorlie T, Eisen MB et al (2000) Molecular portraits of human breast tumours. Nature 406:747–752PubMedCrossRefGoogle Scholar
  3. 3.
    Sorlie T, Perou CM, Tibshirani R et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 98:10869–10874PubMedCrossRefGoogle Scholar
  4. 4.
    Carey LA, Perou CM, Livasy CA et al (2006) Race, breastcancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA 295:2492–2502PubMedCrossRefGoogle Scholar
  5. 5.
    Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V (2007) Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California cancer Registry. Cancer 109:1721–1728PubMedCrossRefGoogle Scholar
  6. 6.
    Haffty BG, Yang Q, Reiss M et al (2006) Locoregional relapse and distant metastasis in conservatively managed triple negative early-stage breast cancer. J Clin Oncol 24:5652–5657PubMedCrossRefGoogle Scholar
  7. 7.
    Lancet (1997) Pathology of familial breast cancer: differences between breast cancers in carriers of BRCA1 or BRCA2 mutations and sporadic cases. Breast Cancer Linkage Consortium. Lancet 349:1505–1510CrossRefGoogle Scholar
  8. 8.
    Eisinger F, Stoppa-Lyonnet D, Longy M et al (1996) Germ line mutation at BRCA1 affects the histoprognostic grade in hereditary breast cancer. Cancer Res 56:471–474PubMedGoogle Scholar
  9. 9.
    Marcus JN, Watson P, Page DL et al (1996) Hereditary breast cancer: pathobiology, prognosis, and BRCA1 and BRCA2 gene linkage. Cancer 77:697–709PubMedCrossRefGoogle Scholar
  10. 10.
    Kriege M, Brekelmans CT, Boetes C et al (2004) Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med 351:427–437PubMedCrossRefGoogle Scholar
  11. 11.
    Kuhl CK, Schmutzler RK, Leutner CC et al (2000) Breast MR imaging screening in 192 women proved or suspected to be carriers of a breast cancer susceptibility gene: preliminary results. Radiology 215:267–279PubMedGoogle Scholar
  12. 12.
    Stoutjesdijk MJ, Boetes C, Jager GJ et al (2001) Magnetic resonance imaging and mammography in women with a hereditary risk of breast cancer. J Natl Cancer Inst 93:1095–1102PubMedCrossRefGoogle Scholar
  13. 13.
    Warner E, Plewes DB, Hill KA et al (2004) Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination. JAMA 292:1317–1325PubMedCrossRefGoogle Scholar
  14. 14.
    Kuhl CK, Schrading S, Leutner CC et al (2005) Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol 23:8469–8476PubMedCrossRefGoogle Scholar
  15. 15.
    Kolb TM, Lichy J, Newhouse JH (1998) Occult cancer in women with dense breasts: detection with screening US—diagnostic yield and tumor characteristics. Radiology 207:191–199PubMedGoogle Scholar
  16. 16.
    Komenaka IK, Ditkoff BA, Joseph KA et al (2004) The development of interval breast malignancies in patients with BRCA mutations. Cancer 100:2079–2083PubMedCrossRefGoogle Scholar
  17. 17.
    Johnson MS, Gonzales MN, Bizila S (2005) Responsible conduct of radiology research. Part V. The Health Insurance Portability and Accountability Act and research. Radiology 237:757–764PubMedCrossRefGoogle Scholar
  18. 18.
    American College of Radiology (ACR) (2003) ACR BI-RADS—Mammography, 4th edn. In: ACR breast imaging reporting and data system, Breast imaging atlas. Reston, VA. American College of RadiologyGoogle Scholar
  19. 19.
    Albain KS, Allred C, Clark GM (1994) Breast cancer outcome and predictors of outcome: are there age differentials? Monogr Natl Cancer Inst 16:335–342Google Scholar
  20. 20.
    Backhouse CM, Lloyd-Davis ER, Shousha S (1987) Carcinoma of the breast in women aged 35 or less. Br J Surg 74:591–593PubMedCrossRefGoogle Scholar
  21. 21.
    Marcus JN, Watson P, Page DL, Lynch HT (1994) Pathology and heredity of breast cancer in younger women. Monogr Natl Cancer Inst 76:23–34Google Scholar
  22. 22.
    Stalsberg H, Thomas DB, Noonan EA (1989) Histologic types of breast carcinoma in relation to international variation and breast cancer risk factors. Int J Cancer 44:399–409PubMedCrossRefGoogle Scholar
  23. 23.
    Moore OS, Foote FW Jr (1949) The relatively favorable prognosis of medullary carcinoma of the breast. Cancer 2:635–642PubMedCrossRefGoogle Scholar
  24. 24.
    Norris HJ, Taylor HB (1970) Carcinoma of the breast in women less than thirty years old. Cancer 26:953–959PubMedCrossRefGoogle Scholar
  25. 25.
    Noyes RD, Spanos WJ, Montague ED (1990) Breast cancer in women aged 30 and under. Invest Radiol 25:67–71CrossRefGoogle Scholar
  26. 26.
    Claus EB, Risch N, Thompson WD, Carter D (1993) Relationship between breast histopathology and family history of breast cancer. Cancer 71:147–153PubMedCrossRefGoogle Scholar
  27. 27.
    Holland R, Peterse JL, Millis RR et al (1994) Ductal carcinoma in situ: a proposal for a new classification. Semin Diagn Pathol 11:167–180PubMedGoogle Scholar
  28. 28.
    Evans A, Pinder S, Wilson R et al (1994) Ductal carcinoma in situ of the breast: correlation between mammographic and pathologic findings. AJR Am J Roentgenol 162:1307–1311PubMedGoogle Scholar
  29. 29.
    Barreau B, Mascarel I, Feuga C et al (2005) Mammography of ductal carcinoma in situ of the breast: review of 909 cases with radiographic-pathologic correlations. Eur J Radiol 54:55–61PubMedCrossRefGoogle Scholar
  30. 30.
    Ferranti C, Coopmans deYoldi G et al (2000) Relationships between age, mammographic features and pathological tumor characteristics in non-palpable breast cancer. Br J Radiol 73:698–705PubMedGoogle Scholar
  31. 31.
    Seo BK, Pisano ED, Kuzimak CM et al (2006) Correlation of HER-2/neu overexpression with mammography and age distribution in primary breast carcinomas. Acad Radiol 13:1211–1218PubMedCrossRefGoogle Scholar
  32. 32.
    Noguchi S, Kasugai T, Miki Y et al (1999) Clinicopathologic analysis of BRCA1- or BRCA2-associated hereditary breast carcinoma in Japanese women. Cancer 85:2200–2205PubMedCrossRefGoogle Scholar
  33. 33.
    Johannsson TO, Idvall I, Anderson C et al (1997) Tumor biological features of BRCA1-induced breast and ovarian cancer. Eur J Cancer 33:362–371PubMedCrossRefGoogle Scholar
  34. 34.
    Crook T, Crossland S, Crompton MR, Osin P, Gusterson BA (1997) P53 mutations in BRCA1-associated familial breast cancer. Lancet 350:638–639PubMedCrossRefGoogle Scholar
  35. 35.
    Lakhani SR, Jacquemier J, Sloane JP et al (1998) Multifactorial analysis of differences between sporadic breast cancers and cancers involving BRCA1 and BRCA2 mutations. J Natl Cancer Inst 90:1138–1145PubMedCrossRefGoogle Scholar
  36. 36.
    Jacquemier J, Eisinger F, Guinebretiere JM, Stoppa-Lyonnet D, Sobol H (1996) Intraductal component and BRCA1-associated breast cancer. Lancet 348:1098CrossRefGoogle Scholar
  37. 37.
    Sun CC, Lenoir G, Lynch H, Narod SA (1996) In-situ breast cancer and BRCA1. Lancet 348:408PubMedCrossRefGoogle Scholar
  38. 38.
    Claus EB, Petruzella S, Matloff E, Carter D (2005) Prevalence of BRCA1 and BRCA2 mutations in women diagnosed with ductal carcinoma in situ. JAMA 293:964–969PubMedCrossRefGoogle Scholar
  39. 39.
    Ridolfi RL, Rosen PP, Port A, Kinne D, Miké V (1977) Medullary carcinoma of the breast. A clinicopathologic study with 10 year follow-up. Cancer 40:1365–1385PubMedCrossRefGoogle Scholar
  40. 40.
    Rapin V, Contesso G, Mouriesse H et al (1988) Medullary breast carcinoma. A reevaluation of 95 cases of breast cancer with inflammatory stroma. Cancer 61:2503–2510PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2007

Authors and Affiliations

  • Wei-Tse Yang
    • 1
  • Mark Dryden
    • 1
  • Kristine Broglio
    • 2
  • Michael Gilcrease
    • 3
  • Shaheenah Dawood
    • 4
  • Peter J. Dempsey
    • 1
  • Vicente Valero
    • 4
  • Gabriel Hortobagyi
    • 4
  • Deann Atchley
    • 4
  • Banu Arun
    • 4
  1. 1.Department of Diagnostic RadiologyThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  2. 2.Department of BiostatisticsThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  3. 3.Department of PathologyThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  4. 4.Department of Breast Medical OncologyThe University of Texas M. D. Anderson Cancer CenterHoustonUSA

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