Division of Medical Oncology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
J Cancer Res Clin Oncol. 2011 Feb;137(2):183-92. doi: 10.1007/s00432-010-0957-x. Epub 2010 Nov 11.
Triple-negative breast cancers (TNBC) neither express hormone receptors, nor overexpress HER2. They are associated with poor prognosis, as defined by low five-year survival and high recurrence rates after adjuvant therapy. Overall, TNBC share striking similarities with basal-like breast cancers (BBC), so a number of studies considered them being the same. The purpose of this review is to summarise the latest findings on TNBC concerning its relation and delineation to BBC, discuss the developmental pathways involved and address clinical implications for this complex type of breast cancer.
The recent literature from PubMed and Medline databases was reviewed.
Not all TNBC are of the intrinsic BBC subtype (nonbasal (NB)-TNBC), nor are all BBC triple-negative (non-triple-negative (NTN)-BBC). There is increasing evidence that a triple-negative, basal-like breast cancer (TNBBC) subtype develops mainly through a BRCA1-related pathway. Somatic mutations that contribute to NTN-BBC and NB-TNBC development are possibly not related to this pathway, but may occur randomly due to increased genomic instability in these tumours. Several therapeutic options exist for TNBBC, which exhibited promising results in recent clinical trials. Cytotoxic therapies, e.g. combined treatment with anthracyclines or taxanes, achieved good tumour regression rates in the neo-adjuvant setting, but also showed considerable recurrence during the first 5 years after therapy. Targeted therapy options involve PARP1 and EGFR inhibition, although both approaches still need further investigation.
TNBC and BBC are not the same disease entity. The TNBBC subtype shows the largest homogeneity in terms of tumour development, prognosis and clinical intervention options.
三阴性乳腺癌（TNBC）既不表达激素受体，也不过表达 HER2。它们的预后较差，定义为辅助治疗后五年生存率低且复发率高。总的来说，TNBC 与基底样乳腺癌（BBC）具有惊人的相似之处，因此许多研究认为它们是相同的。本综述的目的是总结 TNBC 方面的最新发现，包括其与 BBC 的关系和划分，讨论涉及的发育途径，并为这种复杂类型的乳腺癌提供临床意义。
回顾了来自 PubMed 和 Medline 数据库的最新文献。
并非所有的 TNBC 都是固有 BBC 亚型（非基底（NB）-TNBC），也并非所有 BBC 都是三阴性（非三阴性（NTN）-BBC）。越来越多的证据表明，三阴性、基底样乳腺癌（TNBBC）亚型主要通过 BRCA1 相关途径发展。有助于 NTN-BBC 和 NB-TNBC 发展的体细胞突变可能与该途径无关，但由于这些肿瘤中基因组不稳定性增加，可能会随机发生。几种治疗选择存在于 TNBBC 中，在最近的临床试验中显示出有前途的结果。细胞毒性疗法，例如联合使用蒽环类药物或紫杉烷，在新辅助治疗中实现了良好的肿瘤消退率，但在治疗后 5 年内也显示出相当高的复发率。靶向治疗选择涉及 PARP1 和 EGFR 抑制，尽管这两种方法仍需要进一步研究。
TNBC 和 BBC 不是同一种疾病实体。TNBBC 亚型在肿瘤发展、预后和临床干预选择方面具有最大的同质性。
