[Analysis of clinicopathological characteristics and prognosis for triple negative breast cancer: a report of 108 cases]

Yin Guan, Bing-He Xu
Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology] 2008, 30 (3): 196-9

OBJECTIVE: To analyze the incidence, clinical and pathological characteristics, survival and prognostic factors of so-called triple negative breast cancer (TNBC) with negative estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2).

METHODS: Clinical and pathological as well as follow-up data of TNBC patients between Jan. 1999 to Dec. 2002 were collected and analyzed.

RESULTS: Totally, the pathological result of 1175 breast cancer patients were retrospectively reviewed, and 158 patients were found with negative ER, negative PR and HER-2 scored as 0 or 1 + by immunohistochemistry staining. Eventually, only 108 patients with ER-negative, PR-negative and HER-2-negative (score: 0 ) were analyzed. Of the 108 patients, 8 had breast cancer family history, 3 oophoroma family history and one had ever suffered from oophoroma herself. The median age of the 108 TNBC patients was 47.0 years, and 75.0% of them had stage I or II disease. The majority of pathological types were grade II or III invasive ductal carcinomas, and 92.6% of the tumors were staged as T1 or T2. Lymph node metastases were detected in 49. 1% of these patients. Event-free survival, distant metastasis-free survival, local relapse-free survival and overall survival at 5 years were 68.1%, 70.9%, 72.1% and 76.9%, respectively. Though lymph node metastasis and lymph-vascular invasion were all found to be correlated with overall survival, however, only the lymph node metastasis was an independent factor that affected the overall survival revealed by the Cox proportional hazard model analysis.

CONCLUSION: Triple negative breast cancer has distinct clinical and pathologic characteristics. The incidence of triple negative breast cancer in Chinese is similar to that in white but lower than that in black women. Most of the triple negative breast cancer in China is composed of sporadic breast cancer. Lymph node metastasis is an important independent prognostic factor. Clinical outcome of this series is similar to that in white women, while better than that in black women after appropriate radiotherapy and anthracycline-based chemotherapy. Further study is still necessary to explore new treatment in order to improve the prognosis of triple negative breast cancer.

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