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. 

In This Article

Conclusions

Basal-like breast cancer is a heterogeneous group of tumors that is more prevalent in young and African-American patients and is generally associated with a poor outcome. Currently, although it is clearly important that triple-negative cancers be accurately identified in clinical practice for the purposes of management, there is no internationally accepted definition for basal-like cancers and still no clear clinical indication for the routine identification of these tumors as such.[14]

Given that basal-like breast cancers are heterogeneous regardless of the definition used, it is possible that in the next few years, markers that identify subgroups of basal-like or triple-negative cancers that respond to specific agents will become part of our diagnostic armamentarium. With the advent of massively parallel sequencing,[139] which allows for the genome-wide quantitative and qualitative genomic and transcriptomic characterization of cancers, and the imminent death of microarrays,[140,141] it is likely that the taxonomy of breast cancers will be revisited again.[14,56] At that time, it is quite possible that more homogeneous molecular subgroups, their biological drivers, and therapeutic targets will be identified. Until then, it is essential that pathologists continue to strive toward providing optimal assessment of the histological features of breast cancers (including histological grade), as well as accurate determination of ER, PR, and HER2 status according to published guidelines[66,67] as these factors remain the primary determinants of the use and type of systemic therapy for patients with invasive breast cancer.

Comments

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