Which molecular subtype of breast cancer is characterized by high Ki-67, ER-negative, PR-negative, HER2-negative expression, carries the worst prognosis, and benefits most from platinum-based neoadjuvant chemotherapy — particularly in BRCA1-mutated cases?

• A Luminal A
• B HER2-enriched
• C Luminal B HER2+
• D Triple-negative (basal-like) ✓

Explanation

Triple-negative (basal-like) breast cancer lacks ER, PR, and HER2 expression and has the worst prognosis among molecular subtypes due to aggressive biology and lack of targeted therapies. BRCA1-associated tumors are predominantly triple-negative, and BRCA-mutated TNBC shows superior pCR rates with platinum agents (cisplatin/carboplatin) in neoadjuvant regimens. Luminal A has the best prognosis; HER2-enriched responds to trastuzumab-based regimens.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.