Objectives:
Breast cancer is the most common cancer in women. Breast cancer responds variable depending on morphological, clinical, hormonal receptor level differences. In current medical practice ER, PGR, HER2 levels have been important prognostic factors changing the outcome and the treatment modalities.
Methods:
Women operated for breast cancer in our clinic were analysed. 47 cases with negative prognostic and predictive proteins (ER, PGR, HER2) were included in the study. Median follow-up was 36 months and recurrences were evaluated.
Results:
23 (49%) patients were younger than 50, 24 (51%) were older than 50. Most of the cases were invasive ductal carcinoma (78%), second most common was metaplastic carcinoma followed by invasive ductal carcinoma showing myoepithelial differentiation. 36% of the tumors were nuclear grade II, 64% were nuclear grade III. 36% of the tumors had angiolymphatic invasion. Average tumor size was 3.6 cm. 14% of the tumors were T1 (0-2 cm), 86% were T2 (2-5 cm), 10% were T3 (larger than 5 cm). There was no lymph node metastasis in 41.2% of the patients. 58% had lymph node metastasis. Modified radical mastectomy was performed in 68%, 32% had lumpectomy. 92% underwent chemotherapy and radiotherapy. During the 36 month follow up recurrence occured in 17 (36%) cases. 7 were local (41%) and 10 (59%) were distant recurrences.
Conclusion:
Triple negative breast cancers have bad prognosis with high histopathological grade, high risk of invasion and short outcome. Current medical practice focuses on therapies useful for ER, PGR, HER2 positive tumors thus new treatment modalities targeting triple negative breast cancer are needed.
Keywords: HER2, breast cancer, estrogene receptor, progesterone receptor