Original Molecular Classification of Triple Negative Breast Cancer (TNBC)

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Following the description of the main intrinsic breast cancer molecular subtypes based on gene expression analysis:
    • Lehmann et al. demonstrated the complex and heterogeneous nature of TNBCs, and that their definition simply based on interpretation of histopathological features might be of limited efficacy in understanding prognostic behaviour and therapeutic implications
  • They described six subtypes of TNBC based on gene expression analysis of 21 breast cancer data sets:
    • Basal-like type 1 (BL1):
      • Characterized by high proliferative activity demonstrated by elevated Ki67 mRNA expression
    • Basal-like type2 (BL2):
      • Showing basal-myoepithelial phenotype
    • Immunomodulatory (IM) subtype:
      • That includes gene ontologies related to immune cell processes involved in immune signal transduction (such as TH1/TH2, NK and B-cell receptor pathways), in absence of significant correlation with stromal inflammatory cell infiltrate
    • Mesenchymal (M) subtype:
      • That displays genetic patterns responsible for cell motility and cell differentiation processes (i.e. Wnt pathway, ALK pathway)
    • Mesenchymal stem-like (MLS) subtype:
      • Shows genetic profiles associated with growth factors signalling pathways (i.e. EGFR, PDGF) and, particularly, low rates of proliferation genes and low expression of claudins’ family proteins (lately described as claudin-low cancer subtype)
    • LAR subtypes (luminal androgen receptor subtype):
      • Express high levels of androgen receptor hormones (AR) and correlates also with tumors showing apocrine differentiation on histologic examination
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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