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Triple-negatives Mammakarzinom

Klassifikation, aktuelle Konzepte und therapierelevante Faktoren

Triple-negative breast cancer

Classification, current concepts, and therapy-related factors

  • Schwerpunkt: Mammapathologie
  • Published:
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Zusammenfassung

Das triple-negative Mammakarzinom (TNBC) macht ca. 10 % aller Fälle von Brustkrebs aus und ist definiert durch fehlende Expression von Östrogen- und Progesteronrezeptoren sowie durch fehlende Überexpression bzw. Amplifikation von HER2. Es unterscheidet sich vom Hormonrezeptor-positiven Mammakarzinom in Hinblick auf das jüngere Lebensalter der Patientinnen, einer gehäuften Assoziation mit BRCA1-Mutation und einem niedrigeren Differenzierungsgrad. Das Spektrum tripel-negativer Mammakarzinome zeigt eine erhebliche Heterogenität sowohl auf morphologischer als auch molekularer Ebene und umfasst das gewöhnliche TNBC ohne speziellen Typ mit basalem oder nichtbasalem Phänotyp, das tripel-negative metaplastische Mammakarzinom, das triple-negative Mammakarzinom mit apokriner Differenzierung und andere, seltene triple-negativen Tumortypen. Auf Genexpressionsebene ist das TNBC am häufigsten mit einem basalen Phänotyp assoziiert. Seltene molekulare Varianten des TNBC betreffen den Claudin-low-Typ, den molekular-apokrinen Typ und andere besondere Formen. Eine differenzierte Anwendung des Begriffs TNBC unter Berücksichtigung der histopathologischen Differenzierung wird empfohlen.

Abstract

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.

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Authors and Affiliations

  1. Pathologisches Institut, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 220, 69120, Heidelberg, Deutschland

    Hans-Peter Sinn

  2. Institut für Pathologie und Molekularpathologie, Universitätsspital Zürich, Zürich, Schweiz

    Zsuzsanna Varga

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Correspondence to Hans-Peter Sinn.

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H.-P. Sinn und Z. Varga geben an, dass kein Interessenkonflikt besteht.

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Sinn, HP., Varga, Z. Triple-negatives Mammakarzinom. Pathologie 44, 32–38 (2023). https://doi.org/10.1007/s00292-022-01177-y

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