الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Breast cancer constitutes the primary cause of cancer-related morbidity and mortality for women. Patients diagnosed with BC in Egypt are younger, and the Country faces a higher mortality rate related to BC in comparison to Western countries due to advanced disease at presentation.
Triple-negative breast carcinoma is one of the subtypes of breast cancer, known to have a poor prognosis; the most common risk factor is the family history of breast carcinoma, with germline mutation on BRCA1/2 genes being frequently found in comparison to other subtypes. Furthermore, this subtype of breast cancer has no driver mutation that could be targeted. Thus, two modalities of treatment are available now, either chemotherapy or immunotherapy, as this subtype is well known to have high infiltration of T-cells. However, non-metastatic TNBC is highly heterogeneous; two subgroups of patients can be described: on the one hand, patients with high-risk disease, no achieving pCR despite the intensity of neoadjuvant treatment, and on the other hand, a second group of patients with good prognosis, achieving pCR with less pre-surgery treatment. There is an ongoing effort to de-escalate and escalate therapy, tailoring treatment better to the patients who need it at the right time.
The current study was a retrospective observational cohort study including patients diagnosed with non-metastatic TNBC in the Clinical Oncology Department from January 2016 to December 2022. The study included 51 patients and sought to determine the prevalence of germline BRCA1/2 mutations and the expression of PD-L1 along with p53 and TILs. In addition, the study aimed to determine the association between the above markers, the response to treatment, and the clinicopathological characteristics. Pretreatment core biopsies and surgical biopsies for patients who underwent upfront surgery were collected from either the pathology archive or the patients; the paraffin blocks were processed according to the pathology department protocol for IHC-p53 analysis and TILs; IHC PDL-1 was performed in a private accredited laboratory. Patients’ information and the germline BRCA status were obtained from the patient’s medical records; patients without information on germline BRCA were counseled, and tests were done on blood samples.