Main Article Content
triple negative breast cancer, survival, prognosis, radiotherapy
Background: Triple negative breast cancer (TNBC) is the most aggressive and worst prognosis group among breast cancer molecular subtypes. Determining the prognostic factors and parameters affecting survival in the TNBC group were aimed with this retrospective study.
Methods: The patients were divided into two groups as TNBC and non-TNBC. Clinicopathological and treatment parameters of both groups were compared. Survival rates were evaluated using Kaplan Meirer method.
Results: 110(11.1%) of 992 patients were triple negative. 2, 5 and 10-year overall survival (OS) was 91.8%, 75.8%, 64% and 98.5%, 91.3% and 76.2%, respectively in the TNBC and non-TNBC groups. Disease-free survival (DFS) was median 29.7 months in the TNBC group and 52.37 months in the non-TNBC group. The TNBC group has more grade 2-3 tumors (95.8% vs 87.8%, p=0.019), higher ki-67 value (72.7% vs 44.9%, p<0.001), more metastasis presence (28.2% vs 16.2%, p=0.002) and more exitus (28.2% vs 14.5%, p<0.001) than the non-TNBC group. It was not statistically significant as well as local recurrence was higher in the TNBC group. Brain metastasis was observed more frequently in the TNBC group. In the TNBC group, being ≥70 years of age (p=0.05), having T3-4 disease (p=0.040), presence of PNI (p=0.022), presence of metastasis (p<0.001), presence of brain metastasis (p=0.049) had a negative effect on OS in univariate analysis.
Conclusion: Shorter OS and DFS were found in the TNBC group similar to previous studies. Since hormonal treatment cannot be used in this group, individualization of treatments gains importance by knowing the prognostic factors.
2. Zhang J, Wang XX, Lian JY, Song CG. Effect of postmastectomy radiotherapy on triple-negative breast cancer with T1-2 and 1-3 positive axillary lymph nodes: a population-based study using the SEER 18 database. Oncotarget. 2019;10(50):5245-5252. doi:10.18632/oncotarget.24703.
3. Soares RF, Garcia AR, Monteiro AR, Macedo F, Pereira TC, Carvalho JC, et al. Prognostic factors for early relapse in non-metastatic triple negative breast cancer - real world data. Rep Pract Oncol Radiother. 2021;26(4):563-572. doi: 10.5603/RPOR.a2021.0073.
4. De-la-Cruz-Ku G, Luyo M, Morante Z, Enriquez D, Möller MG, Chambergo-Michilot D, et al. Triplenegative breast cancer in Peru: 2000 patients and 15 years of experience. PLoS One. 2020;15(8):e0237811. doi: 10.1371/journal.pone.0237811.
5. Zhang L, Tang R, Deng JP, Zhang WW, Lin HX, Wu SG, He ZY. The effect of postmastectomy radiotherapy in node-positive triple-negative breast cancer. BMC Cancer. 2020;20(1):1146. doi: 10.1186/s12885-020-07639-x.
6. Jitariu AA, Cîmpean AM, Ribatti D, Raica M. Triple negative breast cancer: the kiss of death. Oncotarget. 2017;8(28):46652-46662. doi: 10.18632/oncotarget.16938.
7. Wang C, Kar S, Lai X, Cai W, Arfuso F, Sethi G, et al. Triple negative breast cancer in Asia: An insider's view. Cancer Treat Rev. 2018;62:29-38. doi: 10.1016/j.ctrv.2017.10.014.
8. James M, Dixit A, Robinson B, Frampton C, Davey V. Outcomes for Patients with Non-metastatic Triplenegative Breast Cancer in New Zealand. Clin Oncol (R Coll Radiol). 2019;31(1):17-24. doi: 10.1016/j.clon.2018.09.006.
9. Borri F, Granaglia A. Pathology of triple negative breast cancer. Semin Cancer Biol. 2021;72:136-145. doi: 10.1016/j.semcancer.2020.06.005.
10. Yin L, Duan JJ, Bian XW, Yu SC. Triple-negative breast cancer molecular subtyping and treatment progress. Breast Cancer Res. 2020;22(1):61. doi: 10.1186/s13058-020-01296-5.
11. He MY, Rancoule C, Rehailia-Blanchard A, Espenel S, Trone JC, Bernichon E, et al. Radiotherapy in triple negative breast cancer: Current situation and upcoming strategies. Crit Rev Oncol Hematol. 2018;131:96-101. doi: 10.1016/j.critrevonc.2018.09.004.
12. Tufano AM, Teplinsky E, Landry CA. Updates in Neoadjuvant Therapy for Triple Negative Breast Cancer. Clin Breast Cancer. 2021;21(1):1-9. doi: 10.1016/j.clbc.2020.07.001.
13. Tečić Vuger A, Šeparović R, Vazdar L, Pavlović M, Lepetić P, Šitić S, et al. Characteristics and prognosis of triple-negative breast cancer patients: A Croatian single institution retrospective cohort study. Acta Clin Croat. 2020;59(1):97-108. doi: 10.20471/acc.2020.59.01.12.
14. Yao Y, Chu Y, Xu B, Hu Q, Song Q. Radiotherapy after surgery has significant survival benefits for patients with triple-negative breast cancer. Cancer Med. 2019;8(2):554-563. doi: 10.1002/cam4.1954.
15. EBCTCG (Early Breast Cancer Trialists' Collaborative Group), McGale P, Taylor C, Correa C, Cutter D, Duane F, Ewertz M, et al. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet. 2014;383(9935):2127-35. Erratum in: Lancet. 2014 Nov 22;384(9957):1848. doi: 10.1016/S0140-6736(14)60488-8.
16. NCCN clinical practice guidelines in oncology: breast cancer, version 2 National Comprehensive Cancer Network 2022
17. Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, et al. (Eds.). AJCC Cancer Staging Manual (8th edition). Springer; 2017:589-628
18. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249. doi: 10.3322/caac.21660.
19. Wen S, Manuel L, Doolan M, Westhuyzen J, Shakespeare TP, Aherne NJ. Effect of Clinical and Treatment Factors on Survival Outcomes of Triple Negative Breast Cancer Patients. Breast Cancer (Dove Med Press). 2020;12: 27-35. doi: 10.2147/BCTT.S236483.
20. Kyndi M, Sørensen FB, Knudsen H, Overgaard M, Nielsen HM, Overgaard J; Danish Breast Cancer Cooperative Group. Estrogen receptor, progesterone receptor, HER-2, and response to postmastectomy radiotherapy in high-risk breast cancer: the Danish Breast Cancer Cooperative Group. J Clin Oncol. 2008;26(9):1419-26. doi: 10.1200/JCO.2007.14.5565.
21. Loibl S, Poortmans P, Morrow M, Denkert C, Curigliano G. Breast cancer. Lancet.2021;397(10286):1750-1769 Erratum in: Lancet. 2021 May 8;397(10286):1710. doi: 10.1016/S0140-6736(20)32381-3.
22. Hashmi AA, Hashmi KA, Irfan M, Khan SM, EdhiMM, Ali JP, et al. Ki67 index in intrinsic breast cancer subtypes and its association with prognostic parameters. BMC Res Notes. 2019;12(1):605. doi: 10.1186/s13104-019-4653-x.
23. Zhu X, Chen L, Huang B, Wang Y, Ji L, Wu J, et al. The prognostic and predictive potential of Ki-67 in triple-negative breast cancer. Sci Rep. 2020 Jan 14;10(1):225. doi: 10.1038/s41598-019-57094-3.
Article Statistics :Views : 68 | Downloads : 26