Basal-like and Triple-negative Breast Cancers

A Critical Review With an Emphasis on The Implications for Pathologists and Oncologists

Sunil Badve; David J Dabbs; Stuart J Schnitt; Frederick L Baehner; Thomas Decker; Vincenzo Eusebi; Stephen B Fox; Shu Ichihara; Jocelyne Jacquemier; Sunil R Lakhani; José Palacios; Emad A Rakha; Andrea L Richardson; Fernando C Schmitt; Puay-Hoon Tan; Gary M Tse; Britta Weigelt; Ian O Ellis; Jorge S Reis-Filho

Disclosures

Mod Pathol. 2011;24(2):157-167.

Precursors of Basal-like and Triple-negative Cancers

A group of high-grade DCIS lacking ER, PR and HER2, and expressing 'basal' markers has been identified.^[101–107] However, it should be noted that its prevalence is lower than that of invasive triple-negative and basal-like breast cancers and that triple-negative and basal-like cancers often lack an overt in situ component. Whether this is the result of basal-like and triple-negative breast cancers progressing rapidly from DCIS to invasive cancer and/or obliterating the DCIS precursor from which they arose remains a matter of speculation.

The majority of invasive cancers developing in microglandular adenosis is of triple-negative phenotype^[108–112] and show metaplastic elements or is of adenoid cystic morphology.^[109–112] It has been recently shown that microglandular adenosis may be a nonobligate precursor of triple-negative and basal-like breast cancers.^[108,113] A stepwise progression in the number of gross chromosomal changes from microglandular adenosis to invasive carcinoma has been observed.^[108] However, given the rarity of microglandular adenosis, it is unlikely to be the precursor lesion for most triple-negative cancers.

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Authors and Disclosures

Sunil Badve¹, David J Dabbs², Stuart J Schnitt³, Frederick L Baehner⁴, Thomas Decker⁵, Vincenzo Eusebi⁶, Stephen B Fox⁷, Shu Ichihara⁸, Jocelyne Jacquemier⁹, Sunil R Lakhani¹⁰, José Palacios¹¹, Emad A Rakha¹², Andrea L Richardson¹³, Fernando C Schmitt¹⁴, Puay-Hoon Tan¹⁵, Gary M Tse¹⁶, Britta Weigelt¹⁷, Ian O Ellis¹² and Jorge S Reis-Filho¹⁸

¹Clarian Pathology Lab, Department of Pathology and Internal Medicine, Indiana University, Indianapolis, IN, USA; ²Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; ³Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; ⁴Department of Anatomic Pathology, University of California, San Francisco, CA, USA; ⁵Breast-Screening-Pathology, Gerhard Domagk-Institute of Pathology, Reference Centre Münster, University Hospital Münster, Münster, Germany; ⁶Sezione Anatomia Istologia e Citologia Patologica 'M Malpighi', Università-ASL Ospedale Bellaria, Bologna, Italy; ⁷Pathology Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; ⁸Department of Pathology, Nagoya Medical Center, Nagoya, Japan; ⁹Unité d'Anatomie et de Cytologie Pathologiques, Institut Paoli-Calmettes, Marseille, France; ¹⁰Molecular and Cellular Pathology, University of Queensland Centre for Clinical Research, School of Medicine and Pathology Queensland and The Royal Brisbane and Women's Hospital, Brisbane, Australia; ¹¹Servicio de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla, Spain; ¹²Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK; ¹³Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA; ¹⁴Medical Faculty, Institute of Molecular Pathology and Immunology (IPATIMUP), University of Porto, Porto, Portugal; ¹⁵Department of Pathology, Singapore General Hospital, Singapore, Singapore; ¹⁶Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China; ¹⁷Signal Transduction Laboratory, Cancer Research UK London Research Institute, London, UK; ¹⁸The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK

Correspondence
Professor S Badve, MD, FRCPath, Department of Pathology and Internal Medicine, Indiana University, 350 W 11th Street, Indianapolis, IN 4010, USA; Professor Jorge S Reis-Filho, MD, PhD, FRCPath, The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, 237 Fulham Road, London SW3 6JB, UK. E-mail: sbadve@iupui.edu or jorge.reis-filho@icr.ac.uk

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