Abstract
BackgroundTriple negative breast cancer (TNBC) occurs in approximately 10% to 25% of all patients with breast cancer and is associated with poor prognosis. Neo-adjuvant chemotherapy has been reported to produce a higher pathologic complete response (pCR) rate in TNBC. If pCR is achieved, patients with TNBC had a similar survival with non-TNBC patients. The aim of our study was to investigate the protein expression of epithelial growth factor receptor (EGFR) and response to neo-adjuvant chemotherapy and clinical outcome in patients with TNBC compared with non-TNBC.MethodsA total of 198 locally advanced breast cancer patients who received neo-adjuvant chemotherapy were studied. Immunohistochemistry (IHC) was carried out to detect the protein expression of EGFR in tumor samples. Clinical and pathological parameters, pCR rate and survival data were compared between 40 TNBCs and 158 non-TNBCs.ResultsIn 198 cases who received neo-adjuvant chemotherapy, significant differences exist in surgical therapy (P=0.005) and pCR rate (P=0.012) between patients with TNBCs and non-TNBCs. Overexpression of EGFR was significantly associated with pCR rate in patients with TNBCs (P < 0.001). Survival analysis revealed that patients with TNBCs had worse DFS and OS than those with non-TNBCs (P = 0.001, P < 0.001 respectively). Furthermore, for patients with non-TNBCs, those who acheived pCR had better DFS and OS than those who acheived RD (both P < 0.001).ConclusionsOur results suggested that patients with TNBCs had increased pCR rates compared with non-TNBC. Overexpression of EGFR predicted better response to neo-adjuvant chemotherapy in patients with TNBCs.
Highlights
Triple negative breast cancer (TNBC) occurs in approximately 10% to 25% of all patients with breast cancer and is associated with poor prognosis
Forty (20.20%) cases were designated as TNBCs and 158 (79.80%) patients were non-TNBCs
Number of TNBCs who received standard radical mastectomy was significantly more than nonTNBCs (P= 0.005)
Summary
Triple negative breast cancer (TNBC) occurs in approximately 10% to 25% of all patients with breast cancer and is associated with poor prognosis. The aim of our study was to investigate the protein expression of epithelial growth factor receptor (EGFR) and response to neo-adjuvant chemotherapy and clinical outcome in patients with TNBC compared with non-TNBC. Gene expression analysis has revealed five subgroups of breast cancer (luminal A, luminal B, human epidermal growth factor receptor 2 overexpressing, basal like and normal like) by using DNA microarrays. Triple-negative breast cancer (TNBC) is characterized by lacking of expression of both estrogen receptor (ER) and progesterone receptor (PR) as well as HER2 [6,7] It has some overlap with basal like breast cancer, but the overlap is not complete, because basal like subtype overexpresses myoepithelial cytokeratins (CKs) such as CK 5/6, CK 17 and EGFR [8].
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