Impact of Triple-Negative Breast Cancer Phenotype on Prognosis in Patients with Stage I Breast Cancer.
10.4048/jbc.2012.15.2.197
- Author:
Jeong Eun KIM
1
;
Heui June AHN
;
Jin Hee AHN
;
Dok Hyun YOON
;
Sung Bae KIM
;
Kyung Hae JUNG
;
Gyung Yub GONG
;
Mi Jung KIM
;
Byung Ho SON
;
Sei Hyun AHN
Author Information
1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. drjiny@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Breast neoplasms;
HER2/neu;
Prognosis
- MeSH:
Breast;
Breast Neoplasms;
Chemotherapy, Adjuvant;
Estrogens;
Follow-Up Studies;
Humans;
Multivariate Analysis;
Phenotype;
Prognosis;
Receptors, Progesterone;
Recurrence
- From:Journal of Breast Cancer
2012;15(2):197-202
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Although most patients with stage I breast cancer have a good prognosis, their clinical outcomes may vary significantly. We assessed clinical outcomes and prognostic factors in stage I breast cancer patients with and without triple-negative breast cancer (TNBC) phenotype. METHODS: Of 2,489 patients undergoing breast cancer surgery between January 1998 and December 2002, 554 (22.3%) had stage I breast cancer (tumor size < or =2 cm, and lymph node-negative). TNBC was defined as a primary tumor negative for estrogen and progesterone receptors (Allred scores <3/8) and for HER2/neu (0-1+ by immunohistochemistry). RESULTS: Of the 554 patients with stage I breast cancer, 78 (14.1%) had TNBC. A significant proportion of TNBC patients had histologic grade 3 tumors (47.4% vs. 34.5%, p=0.031) and tumors >1 cm (87.2% vs. 75.8%, p=0.028) and received adjuvant chemotherapy (79.5% vs. 44.7%, p<0.001). During a median follow-up time of 8.7 years, 72 patients experienced tumor recurrences; 18 (23.1%) in the TNBC group and 54 (11.3%) in the non-TNBC group (p=0.010), with cumulative 3-year rate of recurrence of 12.8% and 5.3%, respectively (p=0.010). Ten-year relapse-free survival (RFS; 75.6% vs. 87.5%, p=0.004) and overall survival (OS; 83.0% vs. 91.4%, p=0.002) rates were significantly lower in the TNBC group. Multivariate analysis showed that triple negativity and histologic grade were independent predictors of shorter RFS and OS. CONCLUSION: TNBC had more aggressive clinicopathologic characteristics and was associated with poorer survival in patients with stage I breast cancer. More intensive adjuvant chemotherapy or a different therapeutic strategy targeting this population is warranted.
