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Open Access Highly Accessed Research article

Triple-negative, basal-like, and quintuple-negative breast cancers: better prediction model for survival

Yoon-La Choi12, Ensel Oh34, Sarah Park5, Yeonju Kim6, Yeon-Hee Park7, Kyoung Song3, Eun Yoon Cho2, Yun-Chul Hong8, Jong Sun Choi9, Jeong Eon Lee10, Jung Han Kim10, Seok Jin Nam10, Young-Hyuck Im7, Jung-Hyun Yang10 and Young Kee Shin34*

Author Affiliations

1 Laboratory of Cancer Genomics and Molecular Pathology, Samsung Medical Center, Seoul, Korea

2 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

3 Research Institute of Pharmaceutical Science, Department of Pharmacy, Seoul National University, Seoul, Korea

4 Interdiciplinary Program of Bioinformatics, Department of Natural Science, Seoul National University, Seoul, Korea

5 Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's hospital, Catholic University, Seoul, Korea

6 Cancer Early Detection Branch, National Cancer Control Research Institute, National Cancer Center, Goyang, Korea

7 Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

8 Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea

9 Department of Pathology, Dongguk University-Seoul, Graduate School of Medicine, Seoul, Korea

10 Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

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BMC Cancer 2010, 10:507  doi:10.1186/1471-2407-10-507

Published: 23 September 2010

Abstract

Background

Triple-negative breast cancers (TNBCs) and basal-like breast cancers (BLBCs) are known as poor outcome subtypes with a lack of targeted therapy. Previous studies have shown conflicting results regarding the difference of prognostic significance between TNBCs and BLBCs. In this study, we aimed to characterize the prognostic features of TNBCs, in view of BLBCs and quintuple-negative breast cancers (QNBC/5NPs).

Methods

Using tissue microarray-based immunohistochemical analysis, we categorized 951 primary breast cancers into four or five subtypes according to the expression of ER, PR, HER2, and basal markers (CK5/6, EGFR).

Results

The results of this study showed that both TNBCs and BLBCs were associated with high histological and/or nuclear grades. When the TNBCs are divided into two subtypes by the presence of basal markers, the clinicopathologic characteristics of TNBCs were mainly maintained in the BLBCs. The 5-subgrouping was the better prediction model for both disease free and overall survival in breast cancers than the 4-subgrouping. After multivariate analysis of TNBCs, the BLBCs did not have a worse prognosis than the QNBC/5NPs. Interestingly, the patients with BLBCs showed significant adjuvant chemotherapy benefit. In addition, QNBC/5NPs comprised about 6~8% of breast cancers in publicly available breast cancer datasets

Conclusion

The QNBC/5NP subtype is a worse prognostic subgroup of TNBCs, especially in higher stage and this result may be related to adjuvant chemotherapy benefit of BLBCs, calling for caution in the identification of subgroups of patients for therapeutic classification.