Rakha Emad A, Ellis Ian O
Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.
Pathology. 2009 Jan;41(1):40-7. doi: 10.1080/00313020802563510.
Breast cancer comprises a heterogeneous group of diseases that vary in morphology, biology, behaviour and response to therapy. Triple-negative (TN) breast cancer is a subtype of tumours with aggressive clinical behaviour which currently lacks effective targeted therapies. The majority of TN breast cancers possess a basal phenotype and show varying degrees of basal marker expression (basal-like tumours). The importance of recognising these tumours came to light largely as the result of global gene expression profiling studies that categorised breast cancer into distinct molecular classes. These studies showed that basal-like tumours are molecularly different from hormone receptors and HER2 positive tumours. Although both TN and basal-like tumours share many molecular and morphological features, equating both tumour classes may be misleading. A better understanding of the molecular and histopathological features of TN and basal-like cancers is of paramount importance, in particular for unravelling the heterogeneous nature of these tumour subgroups and for the identification of prognostic biomarkers, ideal systemic therapy regimens and novel therapeutic targets for these aggressive tumours. In this review, we discuss the difference between TN and basal-like tumours, pathological and clinical features of basal-like cancer and hence explore the criteria that can be used to identify these tumours in routine practice.
乳腺癌是一组异质性疾病，在形态、生物学、行为及对治疗的反应方面各不相同。三阴性（TN）乳腺癌是一种具有侵袭性临床行为的肿瘤亚型，目前缺乏有效的靶向治疗方法。大多数TN乳腺癌具有基底样表型，并表现出不同程度的基底标志物表达（基底样肿瘤）。认识到这些肿瘤的重要性很大程度上源于全球基因表达谱研究的结果，这些研究将乳腺癌分为不同的分子类别。这些研究表明，基底样肿瘤在分子层面上与激素受体阳性和HER2阳性肿瘤不同。尽管TN肿瘤和基底样肿瘤具有许多分子和形态学特征，但将这两类肿瘤等同起来可能会产生误导。更好地了解TN和基底样癌的分子和组织病理学特征至关重要，特别是对于阐明这些肿瘤亚组的异质性以及确定预后生物标志物、理想的全身治疗方案和针对这些侵袭性肿瘤的新治疗靶点而言。在本综述中，我们讨论TN和基底样肿瘤之间的差异、基底样癌的病理和临床特征，从而探索在常规实践中可用于识别这些肿瘤的标准。
