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Clinical-pathologic characteristics and response to neoadjuvant chemotherapy in triple-negative low Ki-67 proliferation (TNLP) breast cancers.
Srivastava, Pooja; Wang, Tiannan; Clark, Beth Z; Yu, Jing; Fine, Jeffrey L; Villatoro, Tatiana M; Carter, Gloria J; Brufsky, Adam M; Gorantla, Vikram C; Huggins-Puhalla, Shannon L; Emens, Leisha A; Basili, Thais; da Silva, Edaise M; Reis-Filho, Jorge S; Bhargava, Rohit.
Afiliación
  • Srivastava P; Departments of Pathology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Wang T; Departments of Pathology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Clark BZ; Keck School of Medicine of USC, Los Angeles, CA, USA.
  • Yu J; Departments of Pathology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Fine JL; Departments of Pathology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Villatoro TM; Departments of Pathology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Carter GJ; Departments of Pathology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Brufsky AM; Departments of Pathology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Gorantla VC; Departments of Medical Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Huggins-Puhalla SL; Departments of Medical Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Emens LA; Departments of Medical Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • Basili T; Departments of Medical Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
  • da Silva EM; Department of Pathology, Memorial-Sloan Kettering Cancer Center, New York, NY, USA.
  • Reis-Filho JS; Department of Pathology, Memorial-Sloan Kettering Cancer Center, New York, NY, USA.
  • Bhargava R; Department of Pathology, Memorial-Sloan Kettering Cancer Center, New York, NY, USA.
NPJ Breast Cancer ; 8(1): 51, 2022 Apr 20.
Article en En | MEDLINE | ID: mdl-35444182
Triple-negative breast cancers (TNBCs) often have a high Ki-67 proliferation index and respond favorably to neoadjuvant chemotherapy (NACT) with pathologic complete response (pCR) resulting in ~40% of cases. Nevertheless, morbidity/mortality remain high, mostly due to recurrence in patients with residual disease. In contrast, the incidence and clinical features of TNBC with low proliferation (TNLP), defined as TNBC with a Ki-67 index of ≤30% remains unknown. We report 70 cases of TNLP identified at our center from 2008 to 2018, including 18 treated with NACT. TNLP tumors represent <1% of all breast cancers, and ~5-10% of TNBCs. Ninety percent of carcinomas were grade I/II and 70% were either pure apocrine or showed apocrine differentiation. Fifty cases had available immunohistochemistry results; 80%, 84%, 22%, and 20% were positive for AR, INPP4B, nestin, and SOX10, respectively. With a median follow-up of 72 months, 14% experienced recurrence, and 11% died of breast cancer. The tumor stage was prognostic. Among 39 stage-I patients, 18 (46%) received chemotherapy, but this did not impact survival. There was a trend for improved recurrence-free survival with chemotherapy in stage-II patients. Of the 18 patients treated with NACT, 2 (11%) showed pCR; these were notable for either high stromal TILs or a high mitotic count despite a low Ki-67 index. TNLPs are enriched in low to intermediate-grade carcinomas with apocrine features. Due to overall good prognosis of stage-I TNLP and the lack of clear benefit of chemotherapy, de-escalation of chemotherapy may be considered in select patients with stage-I TNLP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: NPJ Breast Cancer Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: NPJ Breast Cancer Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos