Clinicopathological Features and Metastatic Pattern of Triple-positive Breast Cancer Among Female Patients at a Tertiary Care Hospital

Abstract

ObjectivesThe heterogenicity of breast cancer (BC) is determined by the status of human epidermal growth factor receptor 2 (HER2/neu), estrogen receptor (ER), and progesterone receptor (PR). Triple-positive BC (TPBC) expresses the amplification/overexpression of the HER2 pathway and is positive for ER and PR. This subtype has a distinct clinical behavior. However, very few studies are focused on TPBC. This study investigated the clinicopathological features and metastatic pattern of TPBC.MethodsA seven-year retrospective study was conducted at King Abdulaziz University Hospital in Jeddah, Kingdom of Saudi Arabia. All females with TPBC diagnosed between January 1, 2010, and June 30, 2017, were enrolled. Mean and standard deviation were calculated.ResultsFrom 1205 BC patients, the TPBC incidence was 10% (n = 124). The mean age at diagnosis was 51 years. On physical examination, a high tendency to show pathological skin changes was observed. Invasive ductal carcinoma was the most common histological type, presenting with a poorly differentiated histological grade (grade 3). Over a median two-year follow-up, the incidence of metastasis was 27.4% (n = 34). Bone was the most common site. The incidence of locoregional recurrence was 9.7%. Overall survival was 89.5%.ConclusionTPBC has an early tendency for metastasis and commonly affects the breast skin. BC should be approached based on the immunohistochemical diagnosis. We encourage more comprehensive studies to target TPBC for more insights into the heterogeneity of BC.

Histopathological Patterns and Outcomes of Triple-Positive Versus Triple-Negative Breast Cancer: A Retrospective Study at a Tertiary Cancer Center

“…To our knowledge, this is the first review comparing TNBC and TPBC in terms of behavior and prognosis. In our data, both subtypes had very similar ages at diagnosis, with a mean age of 50.9 in TPBC (SD: 12.7) and 48.7 (SD: 12.1) in TNBC, which is consistent with the mean age at diagnosis found in the literature (the mean age of TPBC is 51 years and TNBC is 49 years) [14,15].…”

“…TNBC usually presents with a higher tumor grade, a larger tumor size, and a worse prognosis with aggressive tendencies [ 8 , 14 ]. TNBC had a mean size of 4.01 cm, while the mean tumor size was 3.26 cm (with a p-value of 0.043).…”

Clinicopathological Features and Metastatic Pattern of Triple Negative Breast Cancer Among Female Patients at a Tertiary Care Hospital

“…These tumors are low-differentiated carcinomas, belonging to the basal-like subgroup, and characterized by frequent local recurrence and organ metastases. [6][7][8][9][10][11][12][13][14] They are associated with the occurrence of hereditary forms of BCs, which are caused by BRCA1 and sometimes by BRCA2 gene mutations. 6 In the present study, the clinicopathological features and metastatic pattern of TNBC were analyzed in 152 female patients with TNBC to determine the relationship between these features and TNBC.…”

“…They are characterized by a frequent local recurrence, organ metastases, 6 and poor outcomes compared with other cancer subtypes. [7][8][9][10][11][12][13][14] They are usually associated with the occurrence of hereditary BCs, which are caused by BRCA1 and rarely BRCA2 gene mutations. 6 However, the current drugs and hormone therapies that target HER2 are unable to treat BC.…”

The Role of the Tumor Microenvironment in Triple-Positive Breast Cancer Progression and Therapeutic Resistance

“…TPBC accounts for approximately 10% to 15% of all breast cancers [12,13]. Its clinicopathological characteristics are predominantly characterized by higher tumor grade, larger volume, inferior prognosis, increased invasiveness, significant vasculaturization or nerve invasion, and a higher likelihood of axillary lymph node and distant metastases, with bone metastases being mostly prevalent [14,15]. TPBC is defined by the positive expression of ER, PR, and HER2.…”