PMID- 33112958
OWN - NLM
STAT- MEDLINE
DCOM- 20210809
LR  - 20220716
IS  - 1543-2165 (Electronic)
IS  - 0003-9985 (Print)
IS  - 0003-9985 (Linking)
VI  - 145
IP  - 6
DP  - 2021 Jun 1
TI  - Triple-Positive Breast Carcinoma: Histopathologic Features and Response to 
      Neoadjuvant Chemotherapy.
PG  - 728-735
LID - 10.5858/arpa.2020-0293-OA [doi]
AB  - CONTEXT.-: It is unclear whether HER2+ tumors expressing both estrogen receptor 
      (ER) and progesterone receptor (PR), that is, triple-positive breast carcinomas 
      (TPBCs), show unique morphologic and clinical features and response to 
      neoadjuvant chemotherapy (NAC). OBJECTIVE.-: To study the morphologic and 
      immunohistochemical features of TPBCs from patients who underwent NAC. DESIGN.-: 
      We retrospectively reviewed core biopsy and post-NAC slides of 85 TPBCs. H-scores 
      were calculated for ER and PR. HER2 slides and fluorescence in situ hybridization 
      (FISH) reports were reviewed. Residual cancer burden was calculated for post-NAC 
      specimens. RESULTS.-: Eighty-one of the 85 tumors (95.3%) showed ductal 
      histology, 3 (3.5%) were invasive lobular carcinomas, and 1 (1.2%) showed mixed 
      ductal and lobular features. A subset showed mucinous (n = 7, 8.2%), apocrine (n 
      = 5, 5.9%), and/or micropapillary (n = 4, 4.7%) differentiation. Fifty-four TPBCs 
      (63.5%) showed high ER expression (H-score >200), including 27 (31.8%) with high 
      expression of ER and PR. Fifty-two tumors (61.1%) showed HER2 3+ staining. Mean 
      HER2/CEP17 ratio by FISH was 3.6 (range, 2-12.2) and mean HER2 signals per cell 
      was 8 (range, 3.7-30.4). Pathologic complete response (pCR) rate was 35.3% (30 of 
      85). HER2 3+ staining was the only significant predictor of pCR on multivariate 
      analysis (odds ratio = 9.215; 95% CI, 2.401-35.371; P < .001). The ER/PR 
      expression did not correlate with response to therapy. CONCLUSIONS.-: TPBCs are 
      heterogeneous with some showing mucinous, lobular, or micropapillary 
      differentiation. The pCR rate of TPBCs is similar to that reported for 
      ER+/PR-/HER2+ tumors. HER2 overexpression by IHC was associated with 
      significantly better response to therapy and may help select patients for 
      treatment in the neoadjuvant setting.
FAU - Zeng, Jennifer
AU  - Zeng J
AD  - From the Departments of Pathology (Zeng, Edelweiss, Ross, Xu, Brogi, D'Alfonso), 
      Memorial Sloan Kettering Cancer Center, New York, New York.
FAU - Edelweiss, Marcia
AU  - Edelweiss M
AD  - From the Departments of Pathology (Zeng, Edelweiss, Ross, Xu, Brogi, D'Alfonso), 
      Memorial Sloan Kettering Cancer Center, New York, New York.
FAU - Ross, Dara S
AU  - Ross DS
AD  - From the Departments of Pathology (Zeng, Edelweiss, Ross, Xu, Brogi, D'Alfonso), 
      Memorial Sloan Kettering Cancer Center, New York, New York.
FAU - Xu, Bin
AU  - Xu B
AD  - From the Departments of Pathology (Zeng, Edelweiss, Ross, Xu, Brogi, D'Alfonso), 
      Memorial Sloan Kettering Cancer Center, New York, New York.
FAU - Moo, Tracy-Ann
AU  - Moo TA
AD  - Breast Surgical Oncology (Moo), Memorial Sloan Kettering Cancer Center, New York, 
      New York.
FAU - Brogi, Edi
AU  - Brogi E
AD  - From the Departments of Pathology (Zeng, Edelweiss, Ross, Xu, Brogi, D'Alfonso), 
      Memorial Sloan Kettering Cancer Center, New York, New York.
FAU - D'Alfonso, Timothy M
AU  - D'Alfonso TM
AD  - From the Departments of Pathology (Zeng, Edelweiss, Ross, Xu, Brogi, D'Alfonso), 
      Memorial Sloan Kettering Cancer Center, New York, New York.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Arch Pathol Lab Med
JT  - Archives of pathology & laboratory medicine
JID - 7607091
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Receptors, Estrogen)
RN  - 0 (Receptors, Progesterone)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Biomarkers, Tumor/genetics/metabolism
MH  - Breast Neoplasms/*drug therapy/genetics/metabolism
MH  - Chemotherapy, Adjuvant/methods
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - In Situ Hybridization, Fluorescence
MH  - Male
MH  - Middle Aged
MH  - Neoadjuvant Therapy
MH  - Neoplasm Staging
MH  - Receptor, ErbB-2/genetics/*metabolism
MH  - Receptors, Estrogen/*metabolism
MH  - Receptors, Progesterone/*metabolism
MH  - Retrospective Studies
PMC - PMC9257671
MID - NIHMS1818319
EDAT- 2020/10/29 06:00
MHDA- 2021/08/10 06:00
PMCR- 2022/07/06
CRDT- 2020/10/28 17:17
PHST- 2020/07/15 00:00 [accepted]
PHST- 2020/10/29 06:00 [pubmed]
PHST- 2021/08/10 06:00 [medline]
PHST- 2020/10/28 17:17 [entrez]
PHST- 2022/07/06 00:00 [pmc-release]
AID - 446876 [pii]
AID - 10.5858/arpa.2020-0293-OA [doi]
PST - ppublish
SO  - Arch Pathol Lab Med. 2021 Jun 1;145(6):728-735. doi: 10.5858/arpa.2020-0293-OA.