title: Clinicopathological, therapeutic and prognostic features of the triple-negative tumors in moroccan breast cancer patients (experience of Hassan II university hospital in Fez).
abstract: BACKGROUND
  Triple-negative breast cancer (TNBC) is defined as a group of breast carcinomas that are negative for expression of hormone receptors (ER, PR) and Her2, we can distinguish between two groups: basal-like (ER-, PR-, Her2-, cytokeratin (CK) 5/6+ and/or Her1+) and unclassified subtype (ER-, PR-, Her2-, Her1- and CK5/6-).The aim of this study is to determine the clinicopathological, histological, therapeutic and prognostic features associated with this type of breast cancer.
  
  
  METHODS
  This is a retrospective study of 366 female breast cancer patients, diagnosed between January 2007 and June 2010 at the Department of Pathology. Epidemiological, clinical, histological, therapeutic and evolutive data were analyzed. OS and DFS rates were estimated by Kaplan-Meier analysis and a log-rank test to estimate outcome.
  
  
  RESULTS
  A total of 64 women were identified as having TNBC (17.5% of all female breast cancer patients), 12.6% were basal-like, 4.9% were unclassified subtype, with a median age of 45 years. The median histological tumor diameter was 4.3 cm. TNBC were most often associated with a high grade, 49.2% grade III (53% for unclassified subtype, 47.6% for basal-like). Vascular invasion was found in 26.6% of cases (22% for unclassified subtype and 28.3% for basal-like). For the lymph node involvement: 51% had positive lymph nodes, and 22.4% had distant metastases. Neoadjuvant chemotherapy was administered to 18% patients with 26% of complete pathologic response; therefore adjuvant chemotherapy was given to 82%. 98% received anthracycline based regimen and only 30% received taxanes.The Kaplan-Meier curves based showed the lowest survival probability at 3-years (49% of OS, and 39% of DFS).
  
  
  CONCLUSIONS
  TNBC is associated with young age, high grade tumors, advanced stage at diagnosis, difference chemo response compared to other subtypes, and shortest survival. Critical to optimal future management is accurate identification of truly triple negative disease, and adequately powered prospective TNBC trials to establish treatment efficacy and define predictive biomarkers.
authors.affiliation: Medical Oncology unit, Hassan II University Hospital, 19 Rue Jebel Zalagh 2 Narjiss C, 30006 Fez, Morocco. you.yous@hotmail.fr.
authors.forename: Yousra
authors.initials: Y
authors.lastname: Akasbi
authors.forename: Sanae
authors.initials: S
authors.lastname: Bennis
authors.forename: Fouad
authors.initials: F
authors.lastname: Abbass
authors.forename: Kawtar
authors.initials: K
authors.lastname: Znati
authors.forename: Khalid Amrani
authors.initials: KA
authors.lastname: Joutei
authors.forename: Afaf
authors.initials: A
authors.lastname: Amarti
authors.forename: Omar El
authors.initials: OE
authors.lastname: Mesbahi
references.citation: Clin Cancer Res. 2007 Apr 15;13(8):2329-34
references.pmid: 17438091
references.citation: Nature. 2000 Aug 17;406(6797):747-52
references.pmid: 10963602
references.citation: J Clin Oncol. 2006 Dec 20;24(36):5652-7
references.pmid: 17116942
references.citation: Clin Cancer Res. 2007 Aug 1;13(15 Pt 1):4429-34
references.pmid: 17671126
references.citation: Clin Cancer Res. 2010 Oct 1;16(19):4702-10
references.pmid: 20858840
references.citation: Cancer. 2007 Oct 15;110(8):1687-96
references.pmid: 17722109
references.citation: J Clin Oncol. 2008 May 20;26(15):2568-81
references.pmid: 18487574
references.citation: Hum Pathol. 2010 Aug;41(8):1186-95
references.pmid: 20381828
references.citation: Clin Cancer Res. 2005 Aug 15;11(16):5678-85
references.pmid: 16115903
references.citation: Nat Rev Cancer. 2004 Oct;4(10):814-9
references.pmid: 15510162
references.citation: J Natl Cancer Inst. 2005 Mar 16;97(6):439-48
references.pmid: 15770008
references.citation: JAMA. 2006 Jun 7;295(21):2492-502
references.pmid: 16757721
references.citation: Proc Natl Acad Sci U S A. 2003 Jul 8;100(14):8418-23
references.pmid: 12829800
references.citation: Mod Pathol. 2006 Feb;19(2):264-71
references.pmid: 16341146
references.citation: Diagn Mol Pathol. 2009 Sep;18(3):125-32
references.pmid: 19704256
references.citation: N Engl J Med. 2009 Jul 9;361(2):123-34
references.pmid: 19553641
references.citation: Breast Cancer Res Treat. 2005 Mar;90(2):157-63
references.pmid: 15803362
references.citation: Clin Cancer Res. 2011 Mar 1;17(5):1082-9
references.pmid: 21233401
references.citation: Cancer Res. 2004 Jun 15;64(12):4218-26
references.pmid: 15205334
references.citation: Clin Cancer Res. 2004 Jan 1;10(1 Pt 1):178-83
references.pmid: 14734467
references.citation: Am J Clin Pathol. 2006 Apr;125(4):512-8
references.pmid: 16627261
references.citation: J Clin Oncol. 2005 Oct 10;23(29):7350-60
references.pmid: 16145060
references.citation: J Natl Cancer Inst. 2003 Oct 1;95(19):1482-5
references.pmid: 14519755