# Clinical and pathologic characteristics of patients with BRCA-positive and BRCA-negative breast cancer

Source: https://onco.cc/key-papers/paper-atchley-brca-status-triple-negative-jco-2008/  
OnCo record `paper-atchley-brca-status-triple-negative-jco-2008` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A 2008 MD Anderson series showing that 57 percent of breast cancers in BRCA1 carriers were triple-negative against 14 percent in women without a BRCA fault, the clinical number behind the rule that triple-negative diagnosis should prompt a genetic test.

## Summary

Atchley, Albarracin, Lopez, Valero and colleagues examined tumour pathology and clinical characteristics in 491 women with breast cancer who had genetic testing for BRCA mutations between 1997 and 2006; 391 were BRCA-negative and 86 BRCA-positive. Triple-negative breast cancer was diagnosed in 57.1 percent of BRCA1-positive patients, 23.3 percent of BRCA2-positive patients and 13.8 percent of BRCA-negative patients. BRCA1 carriers had higher nuclear grade tumours (p<0.001), and among triple-negative patients BRCA2 carriers were older at diagnosis than BRCA1 carriers and non-carriers (p<0.01). The authors suggest BRCA1-associated tumours divide into triple-negative and non-triple-negative groups.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: tnbc-evidence
- Journal: Journal of Clinical Oncology
- Year: 2008
- DOI: 10.1200/JCO.2008.16.6231
- Authors: Atchley DP, Albarracin CT, Lopez A, et al.
- Findings: Triple-negative disease in 57.1 percent of BRCA1 carriers, 23.3 percent of BRCA2 carriers and 13.8 percent of non-carriers.; BRCA1 carriers had higher nuclear grade tumours (p<0.001).
- What it means: Turned the laboratory link between BRCA1 and basal-like biology into a clinical rule: a triple-negative diagnosis is itself a reason to offer germline testing, now embedded in NICE, NCCN and ESMO criteria.
- Caveats: Single-centre series of women referred for genetic testing, so enrichment for hereditary disease is expected.; Retrospective record review.

## Sources

- J Clin Oncol 2008: https://doi.org/10.1200/JCO.2008.16.6231
- PubMed: https://pubmed.ncbi.nlm.nih.gov/18779615/

## Connected records

- cancers: [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- technologies: [Germline (hereditary) testing](https://onco.cc/technologies/germline-testing/)
- targets: [BRCA1 / BRCA2 (HRD)](https://onco.cc/targets/brca/)
- institutions: [MD Anderson Cancer Center](https://onco.cc/institutions/md-anderson/)
- bottlenecks: [Inherited risk is mostly unidentified](https://onco.cc/bottlenecks/b-hereditary-risk/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)
- roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/)
- ideas: [A UK audit of trial access and germline testing uptake in triple-negative breast cancer](https://onco.cc/ideas/idea-tnbc-uk-trial-access-and-germline-testing-audit/)

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