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Triple-Negative Breast Cancer: Subtypes with Clinical Implications

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Precision Molecular Pathology of Breast Cancer

Part of the book series: Molecular Pathology Library ((MPLB,volume 10))

Abstract

Triple-negative breast cancers (TNBC) are a heterogeneous group of malignant breast tumors traditionally defined by their lack of expression of estrogen receptor (ER), progesterone receptor (PR), and over-expression of human epidermal growth factor receptor 2 (HER-2). TNBC accounts for about 10–15 % of all breast cancers. Population-based studies show that women with high body mass index and those who reported no recreational physical activity are at a higher risk for developing TNBC than women who are physically active and those with low body mass index. Interestingly, some factors that are known to decrease the risk of breast cancer in general, do increase the risk of TNBC. These include first childbirth at an early age and multiparity. Racial disparity is also well documented with African-American women having the highest incidence rates for TNBC, followed by Hispanic women. The negativity of these tumors for ER and PR as well as their lack of HER-2 over-expression, render them resistant to hormonal and trastuzumab (Herceptin) therapy, making treatment a challenging task. Although, by DNA microarray analysis, most TNBC will fall into the basal-like category of breast cancers, and therefore will theoretically have a poor prognosis compared to other subtypes, basal-like breast cancer is one of several “faces” of TNBC, albeit the “ugly face.” In this chapter, we will discuss the different subtypes of TNBC, their morphological features, immunophenotype, molecular background, and the clinical implications of these subtypes.

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Authors and Affiliations

  1. Department of Pathology, University of Massachusetts Medical School, UMassMemorial Medical Center, Three Biotech, One Innovation Drive, Worcester, MA, 01605, USA

    Dina Kandil & Ashraf Khan

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  1. Dina Kandil
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  2. Ashraf Khan
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Editors and Affiliations

  1. Department of Pathology, University of Massachusetts Medical School, UMassMemorial Medical Center, Worcester, Massachusetts, USA

    Ashraf Khan

  2. Department of Histopathology, University of Nottingham, Nottingham, United Kingdom

    Ian O. Ellis

  3. Leeds Institute of Cancer and Pathology, St. James University Hospital, Leeds, West Yorkshire, United Kingdom

    Andrew M. Hanby

  4. Department of Pathology, University of Massachusetts Medical School, UMassMemorial Medical Center, Worcester, Massachusetts, USA

    Ediz F. Cosar

  5. Department of Histopathology, University of Nottingham, Nottingham, United Kingdom

    Emad A. Rakha

  6. Department of Pathology, University of Massachusetts Medical School, UMassMemorial Medical Center, Worcester, Massachusetts, USA

    Dina Kandil

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Kandil, D., Khan, A. (2015). Triple-Negative Breast Cancer: Subtypes with Clinical Implications. In: Khan, A., Ellis, I., Hanby, A., Cosar, E., Rakha, E., Kandil, D. (eds) Precision Molecular Pathology of Breast Cancer. Molecular Pathology Library, vol 10. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2886-6_11

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