Cancer du sein triple négatif: Etude clinico-épidémiologique et histopronostique de 90 cas
Mots-clés :
Cancer du sein , triple négatif, Immunohistochimie, TraitementRésumé
Objectif : L’objectif de cette étude est de décrire les caractéristiques clinico- épidémiologiques, histopronostiqueset évolutives des cancers du sein triple négatif (CSTN) dans la population tunisienne.
Patientes et méthodes: Etude rétrospective d’une cohorte de 90 cas de CSTNdiagnostiqués sur une période de deux ans entre Janvier 2008 et Décembre 2009 à l’Institut Salah Azaiz de Tunis.
Résultats: L’incidence du CSTN est de 14%. L’âge moyen des patientes estde 53,67 ans. Des antécédents familiaux de cancer du sein sont rapportés dans 10% des cas. La majorité destumeurs sont classées T2 (41%), de type carcinome canalaire infiltrant (99%)et de grade SBR II (54%). L’envahissement ganglionnaire est observé dans 44% des cas. Le traitement chirurgical est conservateur chez 46% des patientes et radical chez 54% des patientes opérées. La radiothérapie et la chimiothérapie, essentiellement de type FEC, sont administrées chez80% et97% des patientes, respectivement. Un suivi moyen de 33,51 mois montre une rémission complète, une récidive loco-régionaleet une poursuite évolutive sous chimiothérapie dans 61%, 12% et 9% des cas, respectivement. Des métastases systémiques sont diagnostiquées dans 21% des cas.
Conclusions: Le CSTNest souvent diagnostiqué à un stade avancé et présente une tendance à la rechute précoce. L’hétérogénéité de la réponse à la chimiothérapie reflètesa complexité moléculaire. Le développement des thérapies ciblées s’impose pour améliorer le pronostic qui demeure sombre chez les non répondeurs.
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