Clinicopathological features of triple-negative breast cancer in Taiwanese women.

BACKGROUND: The goal of this study was to identify prognostic factors that influence the survival outcome of Taiwanese women with triple-negative breast cancer (TNBC).

METHODS: Of 709 patients with breast cancer diagnosed between January 2002 and December 2005, 152 patients (21.4 %) were diagnosed with TNBC. The overall survival and disease-free survival were estimated using the Kaplan-Meier method and compared between groups using the log-rank test. Univariate and multivariate analyses were used to identify the prognostic factors, and the prognostic significance of these factors in TNBC patients was reviewed.

RESULTS: The median follow-up time was 70.5 months. Kaplan-Meier analysis showed significant difference between the tumor subgroups (TNBC vs. non-TNBC) in 5-year overall survival (p = 0.01) and 5-year disease-free survival (p < 0.0001). Univariate analysis showed that tumor subgroup (TNBC vs. non-TNBC) was a significant predictor of 5-year overall survival and disease-free survival. Tumor size, lymph node status, stage, grade, estrogen receptor status, progesterone receptor status, and HER2 status were also significant. In the multivariate analysis, only tumor size, lymph node status, and grade were significantly related to 5-year overall survival and disease-free survival. In TNBC patients, nodal status was significantly related to 5-year overall survival (HR = 7.47, p < 0.0001) and 5-year disease-free survival (HR = 3.913, p = 0.001).

CONCLUSION: In TNBC, nodal status is a prognostic indicator of survival. The TNBC subgroup had a worse pattern of relapse compared to the non-TNBC, irrespective of nodal negative or nodal positive breast cancer patients. We suggest that this subgroup should receive aggressive treatment to prevent early recurrence or death. Further prospective clinical trials are warranted to identify a more efficient treatment regimen to improve the prognosis.