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.

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.

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Disclosure/conflict of interest
The authors declare no conflict of interest.

Cite this: Basal-like and Triple-negative Breast Cancers - Medscape - Feb 01, 2011.

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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