Sinn Hans-Peter, Varga Zsuzsanna
Pathologisches Institut, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 220, 69120, Heidelberg, Deutschland.
Institut für Pathologie und Molekularpathologie, Universitätsspital Zürich, Zürich, Schweiz.
Pathologie (Heidelb). 2023 Feb;44(1):32-38. doi: 10.1007/s00292-022-01177-y. Epub 2023 Jan 3.
Triple-negative breast cancer (TNBC) accounts for about 10% of all breast cancer cases and is defined by the lack of expression of estrogen and progesterone receptors and the lack of overexpression or amplification of HER2. It differs with regard to the younger age of the patients, an increased association with a mutation of BRCA1 and a mostly low differentiation from hormone receptor-positive breast cancer. The spectrum of triple-negative breast cancer shows considerable heterogeneity both at the morphological and at the molecular level. It includes most commonly TNBC of no special type, with and without basal phenotype, triple-negative metaplastic breast carcinomas, triple-negative breast carcinomas with apocrine differentiation and rare triple-negative tumor types. At the gene-expression level, TNBC most commonly is associated with a basal phenotype, with rarer molecular variants of TNBC involving the Claudin-low, molecular apocrine types, and other rarer subtypes. Therefore, a critical use of the term TNBC, considering the histopathological tumor differentiation, is recommended.
三阴性乳腺癌(TNBC)约占所有乳腺癌病例的10%,其定义为雌激素和孕激素受体表达缺失,且HER2无过表达或扩增。它在患者年龄较轻、与BRCA1突变的关联增加以及与激素受体阳性乳腺癌大多分化程度较低方面有所不同。三阴性乳腺癌的谱系在形态学和分子水平上均表现出相当大的异质性。它最常见的包括无特殊类型的三阴性乳腺癌,有或无基底样表型、三阴性化生性乳腺癌、具有大汗腺分化的三阴性乳腺癌以及罕见的三阴性肿瘤类型。在基因表达水平上,三阴性乳腺癌最常见的与基底样表型相关,三阴性乳腺癌较罕见的分子变体包括Claudin低表达型、分子大汗腺型及其他更罕见的亚型。因此,考虑到组织病理学肿瘤分化情况,建议谨慎使用三阴性乳腺癌这一术语。