Triple-negative breast carcinomas are a heterogeneous entity that differs between young and old patients

Abstract

OBJECTIVE:To compare the frequency and immunohistochemical profiles of triple‐negative breast carcinomas in younger and older women.METHODS AND RESULTS:We selected patients diagnosed with triple‐negative breast carcinomas. The groups examined were women who were 35 years old or younger between 1997 and 2007 (n = 74) and, for comparison, women who were 60 years old or older (n = 19, consecutive cases). All formalin‐fixed and paraffin‐embedded tumor samples were reviewed and immunohistochemically stained for ER, PR, HER2, Ki‐67 antigen, epidermal growth factor receptor, cytokeratin 5/6, p53, vimentin, CD117, and p63 using tissue microarrays blocks. Triple‐negative breast carcinomas corresponded to 34.6% (74/213) of the carcinomas from the younger patients and 16.2% (19/117) of the carcinomas from the older patients (p = 0.002). No significant differences in the frequency of the basal phenotype were observed in the two patient groups based on CK5/6 and/or epidermal growth factor receptor expression (74.3% vs. 68.4%). However, triple‐negative breast carcinomas in the older patients presented a higher frequency of CK5/6 expression compared to those of younger patients (42.1% vs. 9.6%; p = 0.005), whereas triple‐negative breast carcinomas of younger patients had a higher expression level of epidermal growth factor receptor (71.6% vs. 47.3%).CONCLUSIONS:These results show that there were significant molecular differences between the triple‐negative basal‐like breast carcinomas that were diagnosed in younger women and those that were diagnosed in older women. These findings may provide a basis for describing the more aggressive phenotype of the triple‐negative breast carcinomas observed in younger women.

Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer

“…Others have reported on the over-representation of basal-like or triple negative carcinomas among the young [16,17,32]. For example, Carvalho et al found 25.8% of their \35-year-old women had a basal-like phenotype defined as triple negative plus epidermal growth factor receptor (EGFR) and/or cytokeratin (CK) 5/6 positive.…”

“…The molecularly distinct breast cancer subgroups that have been the most reproducibly identified to date include luminal subtypes A and B, the HER2 subtype, and a triple negative group often referred to as basal-like cancers [12][13][14][15]. Few studies, however, have examined the distribution of these molecular phenotypes in young women [16][17][18]. Since, breast cancer in young women has been associated with higher rates of relapse and inferior survival [1][2][3][4][5], it is possible that differing distributions of molecular subtypes in young women may be a major contributor to their poorer prognosis.…”

Clinicopathological features and prognostic factors of young breast cancers in Eastern Guangdong of China

“…Young breast cancer patients were shown to have biologically more ER negative9101112 and higher histological grade, more triple-negative subtype1314, as well as more extensive intraductal component (EIC)12 and fewer ductal carcinoma in situ15. In general, young women seem like to have tumors with more aggressive biological characteristics, after adjusting these factors, age is still an independent factor for prognosis in several studies1617.…”

Expressão de CK5 e vimentina/E-caderina nos diferentes subtipos de carcinomas ductais mamários

“…Apesar de ser considerado um subtipo específico, há uma grande heterogeneidade neste grupo de tumores (Carvalho, Bacchi, Santos, & Bacchi, 2010).…”

“…A expressão de CK5/6 e/ou EGFR tem sido utilizada como marcador para o subtipo basal (Carvalho et al, 2010) (Cheang et al, 2008) ) (Nielsen et al, 2004).…”