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Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis

BACKGROUND: Triple Negative breast cancer (TNBC) includes a heterogeneous group of tumors with different clinico-pathological features, molecular alterations and treatment responsivity. Our aim was to evaluate the clinico-pathological heterogeneity and prognostic significance of TNBC histologic vari...

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Autores principales: Sanges, Francesca, Floris, Matteo, Cossu-Rocca, Paolo, Muroni, Maria R., Pira, Giovanna, Urru, Silvana Anna Maria, Barrocu, Renata, Gallus, Silvano, Bosetti, Cristina, D’Incalci, Maurizio, Manca, Alessandra, Uras, Maria Gabriela, Medda, Ricardo, Sollai, Elisabetta, Murgia, Alma, Palmas, Dolores, Atzori, Francesco, Zinellu, Angelo, Cambosu, Francesca, Moi, Tiziana, Ghiani, Massimo, Marras, Vincenzo, Santona, Maria Cristina, Canu, Luisa, Valle, Enrichetta, Sarobba, Maria Giuseppina, Onnis, Daniela, Asunis, Anna, Cossu, Sergio, Orrù, Sandra, De Miglio, Maria Rosaria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268380/
https://www.ncbi.nlm.nih.gov/pubmed/32487046
http://dx.doi.org/10.1186/s12885-020-06998-9
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author Sanges, Francesca
Floris, Matteo
Cossu-Rocca, Paolo
Muroni, Maria R.
Pira, Giovanna
Urru, Silvana Anna Maria
Barrocu, Renata
Gallus, Silvano
Bosetti, Cristina
D’Incalci, Maurizio
Manca, Alessandra
Uras, Maria Gabriela
Medda, Ricardo
Sollai, Elisabetta
Murgia, Alma
Palmas, Dolores
Atzori, Francesco
Zinellu, Angelo
Cambosu, Francesca
Moi, Tiziana
Ghiani, Massimo
Marras, Vincenzo
Santona, Maria Cristina
Canu, Luisa
Valle, Enrichetta
Sarobba, Maria Giuseppina
Onnis, Daniela
Asunis, Anna
Cossu, Sergio
Orrù, Sandra
De Miglio, Maria Rosaria
author_facet Sanges, Francesca
Floris, Matteo
Cossu-Rocca, Paolo
Muroni, Maria R.
Pira, Giovanna
Urru, Silvana Anna Maria
Barrocu, Renata
Gallus, Silvano
Bosetti, Cristina
D’Incalci, Maurizio
Manca, Alessandra
Uras, Maria Gabriela
Medda, Ricardo
Sollai, Elisabetta
Murgia, Alma
Palmas, Dolores
Atzori, Francesco
Zinellu, Angelo
Cambosu, Francesca
Moi, Tiziana
Ghiani, Massimo
Marras, Vincenzo
Santona, Maria Cristina
Canu, Luisa
Valle, Enrichetta
Sarobba, Maria Giuseppina
Onnis, Daniela
Asunis, Anna
Cossu, Sergio
Orrù, Sandra
De Miglio, Maria Rosaria
author_sort Sanges, Francesca
collection PubMed
description BACKGROUND: Triple Negative breast cancer (TNBC) includes a heterogeneous group of tumors with different clinico-pathological features, molecular alterations and treatment responsivity. Our aim was to evaluate the clinico-pathological heterogeneity and prognostic significance of TNBC histologic variants, comparing “special types” to high-grade invasive breast carcinomas of no special type (IBC-NST). METHODS: This study was performed on data obtained from TNBC Database, including pathological features and clinical records of 1009 TNBCs patients diagnosed between 1994 and 2015 in the four most important Oncology Units located in different hospitals in Sardinia, Italy. Kaplan-Meier analysis, log-rank test and multivariate Cox proportional-hazards regression were applied for overall survival (OS) and disease free survival (DFS) according to TNBC histologic types. RESULTS: TNBC “special types” showed significant differences for several clinico-pathological features when compared to IBC-NST. We observed that in apocrine carcinomas as tumor size increased, the number of metastatic lymph nodes manifestly increased. Adenoid cystic carcinoma showed the smallest tumor size relative to IBC-NST. At five-year follow-up, OS was 92.1, 100.0, and 94.5% for patients with apocrine, adenoid cystic and medullary carcinoma, respectively; patients with lobular and metaplastic carcinoma showed the worst OS, with 79.7 and 84.3%, respectively. At ten-years, patients with adenoid cystic (100.0%) and medullary (94.5%) carcinoma showed a favourable prognosis, whereas patients with lobular carcinoma showed the worst prognosis (73.8%). TNBC medullary type was an independent prognostic factor for DFS compared to IBC-NST. CONCLUSIONS: Our study confirms that an accurate and reliable histopathologic definition of TNBC subtypes has a significant clinical utility and is effective in the therapeutic decision-making process, with the aim to develop innovative and personalized treatments.
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spelling pubmed-72683802020-06-07 Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis Sanges, Francesca Floris, Matteo Cossu-Rocca, Paolo Muroni, Maria R. Pira, Giovanna Urru, Silvana Anna Maria Barrocu, Renata Gallus, Silvano Bosetti, Cristina D’Incalci, Maurizio Manca, Alessandra Uras, Maria Gabriela Medda, Ricardo Sollai, Elisabetta Murgia, Alma Palmas, Dolores Atzori, Francesco Zinellu, Angelo Cambosu, Francesca Moi, Tiziana Ghiani, Massimo Marras, Vincenzo Santona, Maria Cristina Canu, Luisa Valle, Enrichetta Sarobba, Maria Giuseppina Onnis, Daniela Asunis, Anna Cossu, Sergio Orrù, Sandra De Miglio, Maria Rosaria BMC Cancer Research Article BACKGROUND: Triple Negative breast cancer (TNBC) includes a heterogeneous group of tumors with different clinico-pathological features, molecular alterations and treatment responsivity. Our aim was to evaluate the clinico-pathological heterogeneity and prognostic significance of TNBC histologic variants, comparing “special types” to high-grade invasive breast carcinomas of no special type (IBC-NST). METHODS: This study was performed on data obtained from TNBC Database, including pathological features and clinical records of 1009 TNBCs patients diagnosed between 1994 and 2015 in the four most important Oncology Units located in different hospitals in Sardinia, Italy. Kaplan-Meier analysis, log-rank test and multivariate Cox proportional-hazards regression were applied for overall survival (OS) and disease free survival (DFS) according to TNBC histologic types. RESULTS: TNBC “special types” showed significant differences for several clinico-pathological features when compared to IBC-NST. We observed that in apocrine carcinomas as tumor size increased, the number of metastatic lymph nodes manifestly increased. Adenoid cystic carcinoma showed the smallest tumor size relative to IBC-NST. At five-year follow-up, OS was 92.1, 100.0, and 94.5% for patients with apocrine, adenoid cystic and medullary carcinoma, respectively; patients with lobular and metaplastic carcinoma showed the worst OS, with 79.7 and 84.3%, respectively. At ten-years, patients with adenoid cystic (100.0%) and medullary (94.5%) carcinoma showed a favourable prognosis, whereas patients with lobular carcinoma showed the worst prognosis (73.8%). TNBC medullary type was an independent prognostic factor for DFS compared to IBC-NST. CONCLUSIONS: Our study confirms that an accurate and reliable histopathologic definition of TNBC subtypes has a significant clinical utility and is effective in the therapeutic decision-making process, with the aim to develop innovative and personalized treatments. BioMed Central 2020-06-02 /pmc/articles/PMC7268380/ /pubmed/32487046 http://dx.doi.org/10.1186/s12885-020-06998-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Sanges, Francesca
Floris, Matteo
Cossu-Rocca, Paolo
Muroni, Maria R.
Pira, Giovanna
Urru, Silvana Anna Maria
Barrocu, Renata
Gallus, Silvano
Bosetti, Cristina
D’Incalci, Maurizio
Manca, Alessandra
Uras, Maria Gabriela
Medda, Ricardo
Sollai, Elisabetta
Murgia, Alma
Palmas, Dolores
Atzori, Francesco
Zinellu, Angelo
Cambosu, Francesca
Moi, Tiziana
Ghiani, Massimo
Marras, Vincenzo
Santona, Maria Cristina
Canu, Luisa
Valle, Enrichetta
Sarobba, Maria Giuseppina
Onnis, Daniela
Asunis, Anna
Cossu, Sergio
Orrù, Sandra
De Miglio, Maria Rosaria
Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis
title Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis
title_full Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis
title_fullStr Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis
title_full_unstemmed Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis
title_short Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis
title_sort histologic subtyping affecting outcome of triple negative breast cancer: a large sardinian population-based analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268380/
https://www.ncbi.nlm.nih.gov/pubmed/32487046
http://dx.doi.org/10.1186/s12885-020-06998-9
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