title: Heterogeneity of triple-negative breast cancer: histologic subtyping to inform the outcome.
abstract: BACKGROUND
  This study assesses outcome in terms of disease-free survival (DFS) and overall survival (OS) of special types of triple-negative breast cancer (TNBC).
  
  
  METHODS
  We identified 8801 women with first primary nonmetastatic breast cancer operated on at the European Institute of Oncology between 1997 and 2005. Of these patients, 781 consecutive patients with immunohistochemically defined TNBC were selected for the analyses. We explored patterns of recurrence by histologic type. Median follow-up was 5.7 years (range 0-13 years).
  
  
  RESULTS
  The 5-year DFS was 77% for TNBC, 68% for human epidermal growth factor receptor 2 (HER2)-positive breast cancer, and 84% and 95% for luminal B and luminal A breast cancer, respectively. From 781 TNBC subtypes, 693 cases (89%) were classified as ductal not otherwise specified (NOS) (invasive ductal carcinoma [IDC]), 29 were classified as apocrine (3.7%), 18 (2.3%) were classified as lobular, 10 (1.2%) were classified as adenoid cystic, and 10 (1.2%) were classified as metaplastic. Five-year DFS and OS were 77% and 84% for patients with ductal carcinoma, 56% and 89% for patients with metaplastic carcinoma, and both 5-year DFS and OS were 100% for patients with adenoid cystic and medullary carcinomas, respectively.
  
  
  CONCLUSIONS
  Distinct prognostic implications may derive from the specific histotype of TNBC. The identification of these special types has a significant clinical utility and should be considered in therapeutic algorithms.
authors.affiliation: Research Unit in Medical Senology, Department of Medicine, European Institute of Oncology, Milan, Italy. emilia.montagna@ieo.it
authors.forename: Emilia
authors.initials: E
authors.lastname: Montagna
authors.forename: Patrick
authors.initials: P
authors.lastname: Maisonneuve
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cancello
authors.forename: Monica
authors.initials: M
authors.lastname: Iorfida
authors.forename: Alessandra
authors.initials: A
authors.lastname: Balduzzi
authors.forename: Viviana
authors.initials: V
authors.lastname: Galimberti
authors.forename: Paolo
authors.initials: P
authors.lastname: Veronesi
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pruneri
authors.forename: Luca
authors.initials: L
authors.lastname: Bottiglieri
authors.forename: Mauro G
authors.initials: MG
authors.lastname: Mastropasqua
authors.forename: Aron
authors.initials: A
authors.lastname: Goldhirsch
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Marco
authors.initials: M
authors.lastname: Colleoni
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D018275:Carcinoma, Lobular / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone