Características clínicas y pronosticas de los subtipos moleculares de cáncer de mama determinados por Inmunohistoquímica. Arequipa, Perú

Abstract

RESUMENCon el objetivo de determinar las características clínicas y pronósticas de los carcinomas de mama, según sus subtipos moleculares mediante la aplicación de marcadores de inmunohistoquímica, se realizó un estudio en 280 mujeres con cáncer infiltrante de mama unilateral, del 2009 al 2012. Se clasificó por técnicas de inmunohistoquímica en 4 subtipos: luminal A, luminal B, HER2 y triple negativo. Para determinar la influencia del tipo histológico y del subtipo molecular en la sobrevida global, se utilizó el método de Kaplan Meier. Se encontró que los carcinomas de mama fueron: luminal A con 105 (37,5%); luminal B con 88 (31,4%); carcinomas HER2 con 46 (16,4%), y triple negativo con 41 (14,6%). Se concluye que los carcinomas de tipo luminal fueron con mayor frecuencia tumores bien diferenciados, con ganglios axilares negativos, tamaño tumoral y estadio semejante; mientras que los tumores HER2 y triple negativo presentaron mayor proporción de tumores pobremente diferenciados, compromiso ganglionar axilar, y menor sobrevida global.Palabras clave: Neoplasias de la mama; Inmunohistoquimica; Mastectomía; Carcinoma (fuente: DeCS BIREME). CLINICAL AND PROGNOSTIC CHARACTERISTICS OF THE MOLECULAR SUBTYPES OF BREAST CANCER DETERMINED BY IMMUNOHISTOCHEMISTRY. AREQUIPA, PERU ABSTRACTThe objective of this study was to determine the clinical and prognostic characteristics of breast carcinomas according to the molecular subtype using immunohistochemical markers. The study included 280 women with unilateral breast cancer enrolled from 2009 to 2012. The carcinomas were classified into four subtypes based on immunohistochemical findings: luminal A, luminal B, HER2, and triple negative. The Kaplan-Meier test was used to determine the effect of histological type and molecular subtype on overall survival. Our results indicated that the most common breast carcinoma subtype was luminal A (105 cases, 37.5%), followed by luminal B (88 cases, 31.4%), HER2 (46 cases, 16.4%), and triple negative (41 cases, 14.6%). Luminal carcinomas were well-differentiated in most cases, without involvement of the axillary lymph nodes, and showed a similar tumor size and stage. In contrast, HER2 and triple-negative tumors were poorly differentiated in most cases, with axillary node involvement, and were associated with decreased overall survival.

Breast cancer in northern Peru: molecular subtypes and HER2 low

“…However, in our population it was in second place with only 24.7%. On the other hand, luminal B breast cancer was the most frequent subtype with 45.6% compared to 20.0% reported by the international literature and up to 32.0% in national studies 7 , 8 , 9 .…”

“…From 2016 to 2023 there was an inversion of percentages of luminal A and luminal B breast cancer, in favor of the latter. This is a worrying situation since luminal A tumors have better prognosis, longer survival and lower recurrence among all subtypes 3 , 8 . This may be due, in theory, to two circumstances, that there really is an increase in luminal subtype B, or that diagnostic tests have improved its recognition.…”

“…The first one, carried out between 2000 and 2002 by Vallejos et al ., included 1198 patients and concluded that the predominant subtype was luminal A (49.3%), followed by triple negative (21.3%), HER2 positive non luminal (16.2%), and luminal B (13.2%) 7 . Subsequently, Medina, in the years 2009 to 2012, in a series of 280 participants found the following rates: luminal A (37.5%), luminal B (31.4%), HER2 positive non luminal (16.4%), and triple negative (14.6%) 8 . Between 2015 to 2017, Chachaima et al , conducted a study in 259 patients and reported the following: luminal A (40.1%), luminal B (32.4%), triple negative (15.4%), and HER2 positive non luminal (11.9%) 9 .…”

“…El primero, realizado entre 2000 y 2002 por Vallejos et al , estudió 1198 pacientes y concluyó como subtipo predominante luminal A (49,3%), seguido por triple negativo (21,3%), HER2 positivo no luminal (16,2%), y luminal B (13,2%) 7 . Posteriormente, Medina en los años 2009 a 2012, en una serie de 280 encontró: luminal A (37,5%), luminal B (31,4%), HER2 positivo no luminal (16,4%), y triple negativo (14,6%) 8 . Entre los años 2015 a 2017, Chachaima et al , de 259 pacientes publicaron los siguientes resultados: luminal A (40,1%), luminal B (32,4%), triple negativo (15,4%), y HER2 positivo no luminal (11,9%) 9 .…”

Evaluación de una estrategia terapéutica para el cáncer de mama triple negativo basada en el secretoma de células madre mesenquimales del cérvix uterino

“…La clasificación molecular de los carcinomas de mama nos sirve, no solo como factor predictivo de la respuesta al tratamiento hormonal y a la quimioterapia, sino que también nos capacita para un mejor pronóstico. Se ha demostrado que los carcinomas de tipo HER2 y Triple negativo presentan características patológicas más desfavorables y menor supervivencia, mientras que los carcinomas de tipo luminal tienen mayor respuesta terapéutica y por lo tanto, mejor pronóstico (Bueno, 2017).…”