A Prognostic Model for Patients with Triple-Negative Breast Cancer: Importance of the Modified Nottingham Prognostic Index and Age.
- Author:
Jeanny KWON
1
;
Keun Yong EOM
;
Tae Ryool KOO
;
Byoung Hyuck KIM
;
Eunyoung KANG
;
Sung Won KIM
;
Yu Jung KIM
;
So Yeon PARK
;
In Ah KIM
Author Information
- Publication Type:Original Article
- Keywords: Age factors; Prognosis; Triple negative breast neoplasms
- MeSH: Age Factors; Biology; Demography; Disease-Free Survival; Follow-Up Studies; Humans; Multivariate Analysis; Prognosis; Retrospective Studies; Triple Negative Breast Neoplasms*
- From:Journal of Breast Cancer 2017;20(1):65-73
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Considering the distinctive biology of triple-negative breast cancer (TNBC), this study aimed to identify TNBC-specific prognostic factors and determine the prognostic value of the Nottingham Prognostic Index (NPI) and its variant indices. METHODS: A total of 233 patients with newly diagnosed stage I to III TNBC from 2003 to 2012 were reviewed. We retrospectively analyzed the patients' demographics, clinicopathologic parameters, treatment, and survival outcomes. The NPI was calculated as follows: tumor size (cm)×0.2+node status+Scarff-Bloom-Richardson (SBR) grade. The modified NPI (MNPI) was obtained by adding the modified SBR grade rather than the SBR grade. RESULTS: The median follow-up was 67.8 months. Five-year disease-free survival (DFS) and overall survival (OS) were 81.4% and 89.9%, respectively. Multivariate analyses showed that the MNPI was the most significant and common prognostic factor of DFS (p=0.001) and OS (p=0.019). Young age (≤35 years) was also correlated with poor DFS (p=0.006). A recursive partitioning for establishing the prognostic model for DFS was performed based on the results of multivariate analysis. Patients with a low MNPI (≤6.5) were stratified into the low-risk group (p<0.001), and patients with a high MNPI (>6.5) were subdivided into the intermediate (>35 years) and high-risk (≤35 years) groups. Age was not a prognostic factor in patients with a low MNPI, whereas in patients with a high MNPI, it was the second key factor in subdividing patients according to prognosis (p=0.023). CONCLUSION: The MNPI could be used to stratify patients with stage I to III TNBC according to prognosis. It was the most important prognosticator for both DFS and OS. The prognostic significance of young age for DFS differed by MNPI.
