Basal-Like Breast Cancer—Definition and Characteristics

How is Basal-Like Breast Cancer Different From Other Cancers?

Breast cancer cells.
Breast cancer cells. Science Photo Library

What is the definition of basal-like breast cancer, and how is it similar or different from other breast cancers? What treatments are used for this type of breast cancer and what is the prognosis?

Definition: Basal-Like Breast Cancer

Basal-like or basaloid breast cancer is defined by its specific pattern of gene expression that is similar to normal breast basal cells. This type of breast cancer is often triple-negative, meaning that it does not have estrogen, progesterone, or HER2 receptors on the surface of the cells.

How is Basal-Like Breast Cancer Similar and Different From Other Breast Cancers?

Basal-like breast cancer appears to arise in the basal lamina of a breast cancer cell. It is very similar to triple negative breast cancer, but not the same. This is a difficult concept to explain, but even though most triple negative breast cancers are basal-like, and most basal-like breast cancers are triple negative, they do not overlap in all areas.

Characteristics and Risks

Basal-like breast cancer accounts for roughly 15 percent of breast cancers. It is somewhat unique among breast cancers in several ways:

  • It tends to occur in young women, under the age of 40. It is a less common form of breast cancer in men.
  • It is more common in African-American women and possibly Hispanics, and is less common among whites.
  • Many people with this type of cancer, roughly 85 percent, have a p53 gene mutation. The p53 gene codes for a protein that acts to suppress the formation and growth of tumors, and is known as a tumor suppressor gene.
  • This type of cancer is rare among women who have a BRCA1 gene mutation.
  • These cancers tend to have a high grade when viewed under the microscope and be aggressive. After they are treated they have a strong tendency to recur.
  • These cancers tend to be diagnosed at a later stage - when the tumor is larger or has already spread.

    Treatment Options

    Surgery is the treatment of choice for people with basal-like breast cancer. Radiation therapy may be used as well. Although chemotherapy does not work particularly well relative to some other cancers, this therapy is often used for women with this type of breast cancer.

    Since the tumors are estrogen receptor and progesterone receptor negative, hormonal therapies such as Tamoxifen and aromatase inhibitors are not effective in improving the survival of those with the disease.

    Since basal-like breast cancer is usually HER2 negative as well, medications such as Herceptin are not an option.

    Prognosis

    The prognosis of basal-like breast cancer is poorer than with many other types of breast cancer. Part of this is due to the aggressiveness of the tumor, and part because treatments such as hormonal therapy and targeted therapies are not effective.

    Coping

    It can be very frightening to be diagnosed with an uncommon type of breast cancer, especially one that has a poor prognosis. Make sure to express your emotions about your diagnosis. You don't need to "be strong" and you certainly don't have to be positive all the time. Consider joining a support group in your community, or an online cancer community.

    Going online may give you an opportunity to communicate with others facing basal-like breast cancer, not just breast cancer in general. And check out these safe and creative outlets for coping with breast cancer.

    Bottom Line on Basal-Like Breast Cancers

    Any cancer is frightening, but learning that you have basal-like breast cancer can raise your anxiety even further. What does this mean? And when you begin to learn about triple-negative breast cancer it may only compound your nervousness.

    While the prognosis is poorer for tumors that can't be treated with hormonal therapies (that are estrogen receptor negative) or HER2 targeted agents (HER2 positive tumors), there are still options available.

    Surgery can be very effective in early-stage disease, and even for more advanced tumors, these respond quite well to radiation therapy. Chemotherapy has the reputation of being less effective in triple-negative tumors, but many of these tumors do respond.

    With triple-negative breast cancer, you may wish to consider getting a second opinion at one of the larger cancer centers where there are oncologists who specialize in treating this variant of breast cancer. There are several clinical trials in progress and recruiting which are looking at innovative ways to treat these tumors or keep them at bay once surgery is completed. Ask a lot of questions and be your own advocate in your care.

    Pronunciation: BAY-sul sell

    Also Known As: basaloid

    Common Misspellings: basel, basil, baysel

    Sources:

    Fedele, M., Cerchia, L., and G. Chiappetta. The Epithelial-to-Mesenchymal Transition in Breast Cancer: Focus on Basal-Like Carcinomas. Cancers. 2017. 9(10):pii:E134.

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