Background: Triple-negative breast cancer (TNBC) comprises 15-20% of all breast cancers and is marked by early relapse and poor overall survival. Adjuvant chemotherapy has become the standard of care for these patients albeit to this time there is no consensus on its optimal chemotherapy regimen. This study determined the disease-free-survival (DFS) and overall survival (OS) of patients with stage I-III triple-negative breast cancer given adjuvant chemotherapy in Makati Medical Center from 2000 to 2015. Methods: A single institution (Makati Medical Center), retrospective cohort was conducted involving 157 stage I-III triple-negative breast cancer patients, diagnosed from January 2000 to June 2015, who completed an adjuvant chemotherapy regimen and had at least 3 years of follow up with their medical oncologist. Review of charts of these patients was done, and the demographic, clinical, histopathologic, chemotherapy, recurrence and mortality data were collected and analyzed. The OS and DFS rates were estimated using the Kaplan-Meier method. Results: 107 stage I-III triple-negative breast cancer patients who met eligibility criteria were included in the analysis. The most common chemotherapy regimens were sequential anthracycline-taxane (32 patients, 29.09%) and anthracycline-based regimens (32 patients, 29.09%). The 5-year median OS of TNBC patients given adjuvant chemotherapy was 78.94% (95% CI: 69% to 86%) while the 5-year median DFS of TNBC patients was 71.71% (95% CI: 61.68% – 79.5%). There was no significant association between overall survival or disease-free survival and treatment with a particular chemotherapy regimen. Conclusions Adjuvant chemotherapy with sequential anthracycline-taxane, concurrent anthracycline-taxane, CMF, anthracycline-based and taxane-based regimens among stage I-III triple-negative breast cancer patients in Makati Medical Center resulted in comparable overall survival and disease-free survival. The use of immune checkpoint inhibitors presents a viable option in TNBC as demonstrated in the Impassion 130 and KEYNOTE 119 trials, and should be further evaluated in the Philippine setting.
Triple Negative Breast Neoplasms ; Chemotherapy, Adjuvant ; Disease-Free Survival

Background and Objective: The burden of treatment delay in breast cancer is high, especially among developing countries. Despite adversely affecting morbidity and mortality, treatment delay remains unexplored in the Philippines. This study aimed to determine treatment delays among breast cancer patients in a tertiary hospital during surgery, neoadjuvant chemotherapy, and adjuvant chemotherapy, and to identify predictors of delay. Methods: A cross-sectional study was conducted among breast cancer patients seen between January 1, 2012 to December 31, 2018. The following outcomes were investigated: ≥90 days from initial diagnosis to surgery, ≥8 weeks from diagnosis to initiation of neoadjuvant chemotherapy, and >120 days from diagnosis to initiation of adjuvant chemotherapy. Summary statistics were reported as percent for categorical data and as mean for continuous data. The individual correlations were performed using Chi-square for qualitative data and t-test for quantitative data while predictors were determined through logistic regression. Results: A total of 324 patients were included in this study. The majority of the patients were less than 65 years old living in urban areas. More than half of the patients were overweight or obese, hypertensive, and diabetic. The following delays were observed: 61.1% (n = 198) with any type of delay, 23.8% (n = 53) with delay in surgery, 53.8% (n = 120) with delay in adjuvant chemotherapy, and 74.3% (n = 75) with delay in neoadjuvant chemotherapy. The patients noted to have any type of delay were more likely to be hypertensive (p = 0.046) and residing in urban areas (p = 0.041). There were no differences in the distribution of age, body mass index, and presence of co-morbid conditions such as hypertension, diabetes mellitus, coronary artery disease, and heart failure among those with any form of delay compared with no delay. Conclusions The present study shows the presence of treatment delay among breast cancer patients and may be used to enact policy changes to optimize breast cancer care delivery. Further studies may be done to identify other factors affecting these delays and policy changes are recommended to address these gaps in surgery and chemotherapy administration among breast cancer patients.
breast cancer ; quality of care ; treatment delays