Table 2.
Molecular Subtype | ||||
---|---|---|---|---|
Luminal A | Luminal B | HER2/neu | Basal likea | |
Gene expression pattern | Expression of luminal (low molecular weight) cytokeratins, high expression of hormone receptors and related genes | Expression of luminal (low molecular weight) cytokeratins, moderate-low expression of hormone receptors and related genes | High expression of HER2/neu, low expression of ER and related genes | High expression of basal epithelial genes and basal cytokeratins, low expression of ER and related genes, low expression of HER2/neu |
Clinical and biologic properties | 50% of invasive bresat cancer, ER/PR positive, HER2/neu negative | 20% of invasive breast cancer, ER/PR positive, HER2/neu expression variable, higher proliferation than Luminal A, higher histologic grade than Luminal A | 15% of invasive breast cancer, ER/PR negative, HER2/neu positive, high proliferation, diffuse TP53 mutation, high histologic grade and nodal positivity | ~15% of invasive breast cancer, most ER/PR/HER2/neu negative (triple negative), high proliferation, diffuse TP53 mutation, BRCA1 dysfunction (germline, sporadic) |
Histologic correlation | Tubular carcinoma, Cribriform carcinoma, Low grade invasive ductal carcinoma, NOS, Classic lobular carcinomab | Invasive ductal carcinoma, NOS Micropapillary carcinoma | High grade invasive ductal carcinoma, NOS | High grade invasive ductal carcinoma, NOS Metaplastic carcinoma, Medullary carcinoma |
Response to treatment and prognosis | Response to endocrine therapy | Response to endocrine therapy (tamoxifene and aromatase inhibitors) not as good as Luminal A | Response to trastuzumab (Herceptin) | No response to endocrine therapy or trastuzumab |
Variable response to chemotherapy | Variable response to chemotherapy (better than Luminal A) | Response to chemotherapy with antracyclins | Sensitive to platinum group chemotherapy and PARP inhibitors | |
Good prognosis | Prognosis not as good as Luminal A | Usually unfavorable prognosis | Not all, but usually worse prognosis |
PARP poly-adenosinediphosphate ribose polymerase
Basal like tumor group includes a low-grade group with low proliferation but expression of basal type (high molecular weight) cytokeratin and triple negative phenotype ( like adenoid cystic carcinoma, secretuar carcinoma).
Classical lobuler carcinoma generally exhibits luminal A properties, while pleomorphic lobular carcinoma usually shows features of other molecular subtypes.