{"title":"Targeting low-risk triple-negative breast cancer: a review on de-escalation strategies for a new era.","authors":"Filomena Marino Carvalho","doi":"10.21037/tbcr-24-28","DOIUrl":null,"url":null,"abstract":"<p><p>Triple-negative breast cancer (TNBC) is a subtype of breast cancer lacking estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression. Comprising 15-20% of breast cancers, TNBC is typically high-grade, affects younger women, and has a poor prognosis. However, TNBC is heterogeneous, encompassing different molecular subtypes and histological types with distinct molecular drivers, prognoses, and treatment responses. Among these, a subset of low-risk diseases associated with a lower risk of recurrence led to the exploration of de-escalation strategies. This review presents the clinicopathological characteristics of special TNBC with a better prognosis that could be spared from aggressive systemic treatment. We searched the PubMed database for articles that could support treatment de-escalation using the keywords \"early-stage\", \"TNBC\", and \"low-risk\". This article addresses four subgroups of low-risk TNBC: special histological types, tumors with high tumor-infiltrating lymphocytes (TILs), low Ki-67 levels, and early-stage tumors that achieved pathological complete response (pCR). The discussion explores the optimization of treatment options ranging from the omission of any systemic treatment to anthracycline-free possibilities and/or immunotherapies. Identifying these tumors can help personalize treatment, reduce costs and unnecessary toxicity, and contribute to a better quality of life for patients with favorable prognoses. Further studies should explore reliable biomarkers to identify these low-risk diseases precisely.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"6 ","pages":"4"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836748/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational breast cancer research : a journal focusing on translational research in breast cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21037/tbcr-24-28","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Triple-negative breast cancer (TNBC) is a subtype of breast cancer lacking estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression. Comprising 15-20% of breast cancers, TNBC is typically high-grade, affects younger women, and has a poor prognosis. However, TNBC is heterogeneous, encompassing different molecular subtypes and histological types with distinct molecular drivers, prognoses, and treatment responses. Among these, a subset of low-risk diseases associated with a lower risk of recurrence led to the exploration of de-escalation strategies. This review presents the clinicopathological characteristics of special TNBC with a better prognosis that could be spared from aggressive systemic treatment. We searched the PubMed database for articles that could support treatment de-escalation using the keywords "early-stage", "TNBC", and "low-risk". This article addresses four subgroups of low-risk TNBC: special histological types, tumors with high tumor-infiltrating lymphocytes (TILs), low Ki-67 levels, and early-stage tumors that achieved pathological complete response (pCR). The discussion explores the optimization of treatment options ranging from the omission of any systemic treatment to anthracycline-free possibilities and/or immunotherapies. Identifying these tumors can help personalize treatment, reduce costs and unnecessary toxicity, and contribute to a better quality of life for patients with favorable prognoses. Further studies should explore reliable biomarkers to identify these low-risk diseases precisely.