At the 30th Annual Miami Breast cancer conference, this puzzling group of Breast cancer emerged one more time for discussion as it continue to be challenging to investigators. It is a complicated topic because the disease is not unique. Triple negative Breast Cancer is a group of diseases therefore no unique genetic Mutation was brought to light as a determinant driver. Canadian investigators reported Mutations in P53, PTEN and PI3KCA. There was suggestion that as a group TNBC represent 16% of Breast Cancer, And 60% have a morphology pattern of Basal like cell cancers. There is a reported suggestion that these basal like cell cancers had a higher P53 Mutation rate and overall higher genetic variability. How BRCA 1, 2 Mutations fit in the group was not however discussed.
The BRCA Mutations are a challenging on their own. Although they are interpretated to represent a familial tendency to the Breast cancer, it is good to remind ourselves they belong to a group of molecules involved in DNA repair. We know that the neoplastic process does involve destabilizing P53 function and impairing normal control mechanisms including DNA repair and immune normal mechanisms. There is an increased push into finding a way to discern these differences more specifically. Whether family clustering or specific Exons will be used to make the case is still being evaluated.
Given the fact that alteration in Morphology is involved raises the issue of differentiation, status of MEK is of interest to us. This question is of Interest to us because Globally we are talking about one pathway.
RAS/RAF/MEK/MAPK/MYC/FOS/STATs. Disturbance at the Hormone receptors have also been looked at since these will be also ER negative.
Given Metastatic potential of the TNBR, the Wnt pathway is also of interest.
(to be continued)
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