Triple negative breast cancer: proposals for a pragmatic definition and implications for patient management and trial design
- Eiermann, W
- Bergh, J
- Cardoso, F
- Conte, P
- Crown, J
- Curtin, N J
- Gligorov, J
- Gusterson, B
- Joensuu, H
- Linderholm, B K
- Martin, M
- Penault-Llorca, F
- Pestalozzi, B C
- Razis, E
- Sotiriou, C
- Tjulandin, S
- Viale, G
DOIAbstract
In trials in triple negative breast cancer (TNBC), oestrogen and progesterone receptor negativity should be defined as < 1% positive cells. Negativity is a ratio of <2 between Her2 gene copy number and centromere of chromosome 17 or a copy number of 4 or less. In routine practice, immunohistochemistry is acceptable given stringent quality assurance. Triple negativity emerging after neoadjuvant treatment differs from primary TN and such patients should not enter TNBC trials. Patients relapsing with TN metastases should be eligible even if their primary was positive. Rare TN subtypes such as apocrine, adenoid-cystic and low-grade metaplastic tumours should be excluded. TN and basal-like (BL) signatures overlap but are not equivalent. Since th...
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