basal cell?

guitarGrl · November 2008

This came up in another thread, but I don't want it to get lost. Do they routinely test for this? I was reading an article this week that mentioned a targeted therapy that might work for triple negatives who have basal cell, but how do you find out? Does this dx have to be made with the initial pathology report?

susan

tos · November 2008

It is my understanding that they do not usually look for basal at inital biopsy.

I do know one woman who after being diagnosed her doctor told her she was not basal. The Onc may have to order this test.

I stand to be corrected though. I would love to know what this article was that you read about the targeted therapy? We need something so badly.

ravdeb · November 2008

I read that most triple negs in women younger than 50 tend to be basal. I also was wondering if I could get tested for that...

guitarGrl · November 2008

The article citation & abstract are below (from pubmed) - I can't post the article because of copyright laws (besides when I got it from ILL, it came in huge tiff files)

Clin Breast Cancer. 2008 Jun;8(3):215-23.

Beyond cytotoxic chemotherapy for the first-line treatment of HER2-negative, hormone-insensitive metastatic breast cancer: current status and future opportunities.Conlin AK, Seidman AD.Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

As reflected in its varied clinical behavior, appearances under the light microscope, and differential patterns of gene expression, metastatic breast cancer (MBC) is a heterogeneous disease. Systemic treatment decisions are guided by specific tumor characteristics and individual patient factors. For patients with hormone receptor (HR)-negative MBC and for those whose HR-positive disease has become refractory to hormonal therapies, cytotoxic chemotherapy has been the mainstay of systemic treatment. For hormone-insensitive, HER2-positive MBCs, the addition of trastuzumab to chemotherapy has resulted in improved outcomes. Hormone-insensitive MBC lacking HER2 overexpression includes the subset of patients with estrogen receptor/ progesterone receptor/HER2-negative (so-called triple-negative) disease, which represents a significant minority of all breast cancers. Therapeutic options for such patients are limited by the lack of specific targeted approaches, and this heterogeneous group will be considered collectively as well as separately in this overview of existing and emerging treatment strategies. Conventional cytotoxic chemotherapy, alone or in combination, has been the standard first-line treatment for patients with MBC not amenable to antiestrogen or trastuzumab therapy. The recent evaluation of new targeted therapies in combination with cytotoxic agents has created a new type of combination regimen. Agents targeting angiogenesis, the epidermal growth factor receptor, and various signal transduction pathways have been combined with chemotherapy and possess biologic activity in MBC. As these combinations are being investigated, parallel correlative studies aimed at enriching the population who will benefit most are under way.

Boo46 · November 2008

Hi Guitargirl,

I do have the basal-like type trip neg bc. I was diagnosed in 2006. My onc had testing for basal-like subtype done 2 months after my initial pathology. Tissue from my initial tumor removal was used. I pulled out my pathology report about it so I wouldn't miss quote.

ADDENDUM

Additional immunohistochemical staining of this tumor was performed as follows:

Due to the high grade histology and negative expression of estrogen receptors, progesterone receptors, and absence of HER-2/neu over expression ("triple negative" phenotype), this case was further evaluated for the possibility of basal-like phenotype expression using immunohistochemical stains to Vimentin, EGFR, and Cytokeratin 5,6. The pattern of expression of these stains supports high likelyhood of a basal-like phenotype. Basal-like phenotype has been associated with a less favorable outcome.

At the time (Aug 2006) my onc had nothing different to offer treatment wise based on these findings. He wanted the results I think because it was fairly new that differences were being defined in trip negs. For me it was just one more paper with "prognosis unfavorable" on it Frown .

My onc told me at the time that belief was that basal-like trip neg was even more chemo responsive than non basal-like trip neg. Don't know if that is turning out to be true but I am 2 1/2 years post DX and NED.

I don't know of any targeted treatment for basal-type but sure hope they are developing one.

Sue

guitarGrl · November 2008

Sue -

Thanks for the info & glad they were wrong about you so far. I'll try to read the article again & find the relevant parts about basal cells. The article was a bit more scientific than this artist could digest.

susan

sftfemme65 · November 2008

So does anyone know if you can be a grade 2 and have basal cell?

Teresa

sftfemme65 · November 2008

Does anyone know if you can be a grade 2 and have basal cell?

Boo46 · November 2008

Teresa,

I don't know the answer to your question. I'm not sure how many of us trip negs have had further testing done to see if the basal-like phenotype is present. If I can find an answer to your question I will post it.

Hugs,

Sue

basal cell?

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