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Is it possible to identify subpopulations of triple negative breast cancer?


Obstetrics & Gynecology International Journal
Alfredo Camargo MD PhD,1,2 Federico Bianchi MD,1 Tomas Ramilo MD,1 Tomas Garcia Balcarce MD,1 Agustin Boixart MD,1 Barreto Mariela MD,1 Frahm Isabel MD,2 Roberto Castaño MD PhD1

Abstract

Introduction: Numerous publications have individually evaluated the expression of the p53 protein, the presence of androgen receptors and the magnitude of the lymphocyte infiltrate TILs in triple negative tumors. The presence or absence of these variables could help identify subgroups in triple negative breast cancer (TNBC).
Objectives: The objective of this study is to evaluate in triple negative tumors feasibility of using lymphocyte infiltration, the expression of p53 protein and androgen receptors as prognostic markers (overall survival and disease-free) .and collaborate in the identification of biomarkers for the development of specific target treatments.
Material and Methods: We intend to analyze those patients diagnosed with TNBC treated at the German Hospital of Buenos Aires and at the Mater Dei Sanatorium from December 2002 to December 2014.
Results: Thirty-five patients with TNBC were analyzed. The prevalence in the p53 mutation was 57% in the general population, 64,7% in relapses and 69% in deceased patients. 22.8% of the patients studied showed expression of androgenic receptors. The average lymphocytic tumor infiltration (TILs) was 20.6% (5%-70%), being lower when the population of patients who relapsed was only evaluated (19.6%) and even lower when evaluating the population of deceased patients (17.1%).
Discussion: The mutation in p53 in our population has a RR of 1.6 for survival with a p = 0.596. The presence of ILV together with the mutation in p53 constitutes a mortality risk factor with p = 0.0147. The expression of androgenic receptors has a RR of 1.5 as a mortality risk factor and a p: 0.974. The presence of TILS greater than 20% is predictive of mortality and recurrence with a p: 0.0269. This is maintained with values of TILs of 18% and 15% with p = 0.0131 and p = 0.0032 respectively.
Conclusion: The determination of the TILs together with the evaluation of the mutation of the p53, and its evaluation in combination with other prognostic factors (ILV and Ki67) is useful for predicting prognosis in the TNBC. We think that the presence of mutation of p53 and the degree of TILs are determinations whose evaluation should be standardized in patients with TNBC and be duly recorded in the pathology report.

Keywords

triple negative, p53, androgenic receptors, TILs

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