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Detecting the expression of HRs and BCL2 via IHC can help identify luminal A-like subtypes of triple-positive breast cancers

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Abstract

Background

Triple-positive breast cancer (TPBC) is a tumor that simultaneously expresses estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). Luminal A-like TPBC is a special subtype with a favorable prognosis but benefits less from HER2-targeted therapy. However, little is known about how to identify luminal A-like TPBCs. Therefore, our study aims to explore a clinically feasible method to identify luminal A-like TPBCs using immunohistochemical (IHC) markers.

Methods

Our cohort enrolled consecutive 190 patients with early-stage TPBCs diagnosed, treated and followed up in our hospital between 2013 and 2019. Patients whose IHC staining displayed ≥ 50% in both ER and PR scores and B-cell lymphoma 2 (BCL2) positivity were classified as cohort A (n = 64), and the rest were enrolled in cohort B (n = 126). Kaplan–Meier plotter and log-rank test were used to compare the survival difference between cohort A and cohort B and the efficacy of trastuzumab therapy in the two cohorts.

Results

The disease-free survival (DFS) of patients in cohort A was significantly better than in cohort B (p = 0.031). In cohort A, there was no statistically significant difference in DFS between patients treated with trastuzumab and those without trastuzumab (p = 0.663). While in cohort B, patients treated with trastuzumab had significantly better DFS than those without trastuzumab (p = 0.032). Multivariate survival analysis showed that cohort A was associated with better DFS(95%CI 1.046–11.776, p = 0.042).

Conclusion

TPBCs consist of heterogeneous subtypes. Detecting the expression of ER, PR and BCL2 via IHC can help identify luminal A-like TPBCs. This study will enable individualized treatment of TPBCs.

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Availability of data and materials

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

This research did not receive any specific grant from funding agencies from any public, commercial, or not-for-profit sectors.

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Author notes

  1. Yingying Xu and Yonghao Liang are contributed equally to this work.

Authors and Affiliations

  1. Department of Breast Surgery, Second Hospital of Jilin University, Changchun, 130041, China

    Yingying Xu, Yonghao Liang & Guanghao Yin

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  1. Yingying Xu
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Contributions

GY and YX contributed to the conception and design of the study; All authors collected the data; YX and YL analyzed the data and wrote the manuscript.

Corresponding author

Correspondence to Guanghao Yin.

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No authors have any conflicts of interest to disclose.

Ethical approval

The independent ethics committee/institutional review board of the Second Hospital of Jilin University approved our study (Approval Number: 2022-157). The requirement for informed patient consent was waived due to the study's retrospective nature.

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Because of the retrospective nature of the study and the lack of personal details of participants that compromise anonymity, consent was waived.

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Xu, Y., Liang, Y. & Yin, G. Detecting the expression of HRs and BCL2 via IHC can help identify luminal A-like subtypes of triple-positive breast cancers. Clin Transl Oncol 25, 1024–1032 (2023). https://doi.org/10.1007/s12094-022-03007-2

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