Clinical Features and Presentation of Triple Negative Breast Cancers

  • The majority of TNBCs are detected clinically as a:
    • Mass, either by the patient or examining clinician
  • Other possible presenting symptoms include:
    • Breast pain
    • Bloody nipple discharge
  • In the institutional review by Krizmanich-Conniff and colleagues, when compared with non-TNBCs:
    • TNBCs were more likely to present clinically:
      • 68% versus 48%
    • The remaining 32% of TNBCs were found on screening mammography:
      • Whereas 52% of non-TNBCs were found by screening
  • More than one-third of patients whose TNBC was detected clinically had no prior mammography:
    • Of those detected by mammography:
      • One-third had developed within 12 months of the last mammography:
        • The high incidence of interval cancers is attributed to the aggressive growth rate of TNBC
  • Imaging:
    • Mammographic characteristics of TNBC included:
      • A round mass (59.3%) or an oval or lobulated mass (65%), with circumscribed (15%), microlobulated (12.5%), or indistinct margins (55%)
      • Spiculated margins were much less common (15%)
  • On mammography, TNBCs are most likely seen as:
    • A noncalcified mass:
      • 58%
  • Dogan and Turnbull caution that TNBC may lack the typical mammographic features of breast cancer, and although ultrasonography adds to the sensitivity of diagnosis:
    • 21% to 41% of TNBCs can have benign characteristics on breast imaging
  • On MRI, the most common enhancement pattern seen with TNBC is rim enhancement:
    • MRI findings following neoadjuvant chemotherapy (NAC):
      • Correlate well with the extent of residual tumor
    • MRI provides a reliable baseline prior to NAC and can predict response more sensitively than other imaging methods

#Arrangoiz #CancerSurgeon #BreastSurgeon #SurgicalOncologist #ComplexSurgicalOncology #BreastCancer #TripleNegativeBreastCancer #TNBC #Miami #Mexico #Teacher #Surgeon #MountSinaiMedicalCenter #MSMC

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