Newman Lisa A, Reis-Filho Jorge S, Morrow Monica, Carey Lisa A, King Tari A
Department of Surgery, University of Michigan Breast Care Center, University of Michigan Health Systems, Ann Arbor, MI, USA.
Ann Surg Oncol. 2015 Mar;22(3):874-82. doi: 10.1245/s10434-014-4279-0. Epub 2014 Dec 20.
Triple-negative breast cancer (TNBC) is an operational term that refers to a heterogeneous collection of breast cancers lacking expression of estrogen receptor (ER), progesterone receptor, and HER2. These tumors account for 12-17 % of all breast cancers, preferentially affect young women, are more frequent in women of African and Hispanic descent, and are enriched in the population of patients diagnosed with "interval cancers." TNBCs account for the majority of breast cancers arising in BRCA1 germline mutation carriers (approximately 80%), and approximately 11-16% of all TNBCs harbor BRCA1 or BRCA2 germline mutations. Well-known risk factors for ER-positive cancers, such as reproductive history and hormonal factors, do not appear to have the same correlations for TNBC, and histologic risk factors for TNBC have not been identified. Patients with TNBC have a higher risk of both local and distant recurrence, but this is not mitigated by bigger surgery, and standard criteria should be used to select the approach to local therapy in these patients. Although platinum drugs have shown promise in the treatment of TNBC, standard chemotherapy remains the standard of care outside of a clinical trial.
三阴性乳腺癌(TNBC)是一个操作性术语,指的是一组异质性乳腺癌,这些乳腺癌缺乏雌激素受体(ER)、孕激素受体和HER2的表达。这些肿瘤占所有乳腺癌的12%-17%,优先影响年轻女性,在非洲裔和西班牙裔女性中更为常见,并且在被诊断为“间期癌”的患者群体中更为富集。TNBC占BRCA1种系突变携带者中发生的乳腺癌的大多数(约80%),并且所有TNBC中约11%-16%携带BRCA1或BRCA2种系突变。ER阳性癌症的众所周知的风险因素,如生殖史和激素因素,似乎与TNBC没有相同的相关性,并且尚未确定TNBC的组织学风险因素。TNBC患者局部和远处复发的风险更高,但这并不会因更大范围的手术而减轻,并且应使用标准标准来选择这些患者的局部治疗方法。尽管铂类药物在TNBC治疗中显示出前景,但在临床试验之外,标准化化疗仍然是标准的治疗方法。