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 Basal - Like Molecular Subtype

Identified through high-throughput gene expression micro-array analysis

  • Affects 15% - 20% of all breast cancer patients

    • Up to 45% of African, Middle Eastern and Ashkenazi Jewish women​

  • Affects younger patients

  • Associated with BRCA1 mutation

  • Majority are Invasive Ductile Carcinoma of No Special Type

Aggressive Clinical Behavior

  • Heterogeneous invasive sub-type of breast cancer

  • Highly proliferative - High mitotic index

  • Rapid growth rate

  • Early recurrence

  • Decreased overall survival

  • BLBC does not disseminate to lymph nodes and bones

    • Regional node negative

    • Hematogenesis metastasis via vascular invasion (lymph node negative)

    • Distant site metastasis favors brain and lungs

Partha S. Ray, MD

Founder,  Director, Chairman-Med/Sci Advisory Board

BLBC

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Interviewed by

Jim Fitzpatrick:

Aggressive Clin Behavior

Basal - Luminal & Basal - HER 2

Missed Diagnosis

  • The basal - like subtype has been identified in 20% to 30% of the ER+ and HER2+ tumors

  • Should cancer reoccur, there is a 30% chance that the original cancer has changed characteristics

    • Often to the more aggressive BLBC sub-type

  • The Triple Negative IHC nomenclature presents ER+ or HER2+ tumors and BLBC as mutually exclusive​

  • Molecular subtyping demonstrates the heterogeneity of breast cancer.

  • The introduction of AVISI0™ FOXC1 IHC as the fourth breast cancer biomarker routinely used in the clinical laboratory makes TNBC even more archaic for we have identified a NEW QNBC (Quadruple Negative Breast Cancer)

Basal-Luminal & Basal HER2

No Diagnostic Assay (Until Today)

Diagnosed 2 to 5 years after initial diagnosis

Symptoms worst than initial presentation

Effective therapy has already been compromised

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  • Poor "Triple Negative" surrogate, ruling out other forms of breast cancer (ER-, PR-, HER2-), to make a presumptive diagnosis

  •  BLBC does not metastasize to regional lymph nodes                                                              

    • Vascular invasion is the preferred route of metastasis

  • Heterogeneous molecular phenotype​

  • Overlapping molecular sub-types and histological sub-types

Breast Cancer Molecular Phylogeny

Venkatraman B. Identifying gaps and relative opportunities for discovering membrane proteomic biomarkers of triple-negative breast cancer as a translational priority. Cancer Transl Med [serial online] 2016 [cited 2018 Jan 5];2:137-46. Available from: http://www.cancertm.com/text.asp?2016/2/5/137/192931

Intrinsic Molecular Subtype vs. IHC Phenotype

Dai X, Li T, Bai Z, et al. Breast cancer intrinsic subtype classification, clinical use and future trends. ]American Journal of Cancer Research. 2015; [cited 2018 Jan 5]; 5(10):2929. Available from:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4656721/

FOXC1
No Diagnostic Assay
Molecular Phylogeny
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