Abstract
At present, breast cancer (BC) has the highest incidence among the most common forms of cancer in women, almost one million women being diagnosed annually worldwide. However, in recent years BC has registered a low mortality rate mainly in developed, high-income countries. The triple negative breast cancer (TNBC) is a subtype of BC which is characterized by the absence of protein expression of the two hormone receptors-estrogen (ER) and progesterone (PgR) after immunohistochemistry (IHC) analysis and the lack of overexpression of the human epidermal growth factor receptor 2 (HER2) after IHC or in situ fluorescence hybridization technique. More than 170,000 of women are currently diagnosed with TNBC (ER–/PR–/HER2) representing 12-20% of all BC. TNBCs are recognized to have a poor prognosis which translates into a relative low disease-free survival rate for women who receive either neoadjuvant or adjuvant chemotherapy as well as a low progression-free survival rate for women who develop distant metastases. Furthermore, biologically, they are much more aggressive than the other types of BC and, owing to their triple “negativity”, a targeted therapy with anti-hormon agents or transtuzumab (anti HER2) cannot be utilized. The aim of this paper is to make a review of the current scientific evidence with regard to the new chemotherapeutic agents used in the neoadjuvant setting as well as the role of surgical treatment in women diagnosed with TNBC.
Highlights
Worldwide, breast cancer (BC) is the most common cancer among women, 23% of all new diagnosed cancers being BC
triple negative breast cancer (TNBC) is encountered in almost 39% of all AfroAmerican women in premenopausal age, a percentage which is 3-fold higher than that of TNBC in white women as presented in 2006 in San Antonio Breast Cancer Symposium. [4,5] Females who develop TNBC are younger than those with ER+/ Her2 + or with ER+/Her2, live in low socioeconomic conditions and generally present an aggressive clinical course with low OS and DFS rates in the adjuvant and neoadjuvant setting
(6) Dent and his coworkers [7] presented their study at the 2015 American Society of Clinical Oncology (ASCO) Meeting and showed that of 10,000 women diagnosed with TNBC in the USA in 2010 and 2011, 34% were at stage I, 42% at stage II, 15% at stage III, and 6% at stage IV
Summary
Breast cancer (BC) is the most common cancer among women, 23% of all new diagnosed cancers being BC. TNBC comprises several molecular subtypes which require different treatment options and are more or less sensitive to chemotherapy or biological agents. Besides the high probability of coexistence of the BRCA1 mutation, TNBC have a generally weak prognosis with a high risk of early relapse after completion after the adjuvant treatment, especially during the first and third year. They grow quickly and their tissular density resemble that of the normal tissue. Our purpose is to present the current therapeutic possibilities for women diagnosed with TNBC
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