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Triple-negative breast cancer (TNBC) patients classified as basal-like immune-suppressed (BLIS) show higher locoregional recurrence (LRR) rates. Immunohistochemistry (IHC) subtyping can identify high-risk BLIS patients for tailored postmastectomy radiation therapy.

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Area of Science:

  • Oncology
  • Breast Cancer Research
  • Molecular Pathology

Background:

  • Triple-negative breast cancer (TNBC) lacks targeted therapies, making molecular subtyping crucial for treatment stratification.
  • Immunohistochemistry (IHC)-based subtyping offers a comprehensive profile for TNBC, aiding in understanding disease heterogeneity.
  • Locoregional recurrence (LRR) remains a significant concern in TNBC management, necessitating improved prognostic markers.

Purpose of the Study:

  • To investigate the patterns of locoregional recurrence (LRR) in different molecular subtypes of triple-negative breast cancer (TNBC).
  • To compare LRR, disease-free survival, and overall survival (OS) between basal-like immune-suppressed (BLIS) and non-BLIS TNBC subtypes.
  • To evaluate the prognostic value of IHC-based molecular subtyping for LRR and survival outcomes in TNBC patients.

Main Methods:

  • Retrospective analysis of 352 TNBC patients treated with mastectomy and postmastectomy radiation therapy.
  • Classification of patients into basal-like immune-suppressed (BLIS) and non-BLIS groups based on IHC markers.
  • Comparison of LRR, disease-free survival, and OS using univariate and multivariate analyses.

Main Results:

  • The BLIS subtype showed a significantly higher cumulative incidence of LRR (14.9%) compared to the non-BLIS group (5.8%) (P = .005).
  • Overall survival (OS) was significantly lower in the BLIS group (83.0%) versus the non-BLIS group (91.9%) (P = .01).
  • Multivariate analysis confirmed IHC-based molecular subtyping as an independent prognostic factor for LRR and OS (P = .03 for both).

Conclusions:

  • The BLIS subtype of TNBC is associated with an increased risk of locoregional recurrence.
  • IHC-based molecular subtyping can serve as a prognostic biomarker to guide postmastectomy radiation therapy decisions in TNBC.
  • Novel therapeutic strategies are needed to enhance locoregional control rates in patients with the BLIS subtype of TNBC.