Browse > Article
http://dx.doi.org/10.7314/APJCP.2014.15.6.2577

Outcomes of Triple-Negative Versus Non-Triple-Negative Breast Cancers Managed with Breast-Conserving Therapy  

Bhatti, Abu Bakar Hafeez (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre)
Khan, Amina Iqbal (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre)
Siddiqui, Neelam (Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre)
Muzaffar, Nargis (Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre)
Syed, Aamir Ali (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre)
Shah, Mazhar Ali (Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre)
Jamshed, Arif (Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.15, no.6, 2014 , pp. 2577-2581 More about this Journal
Abstract
Background: Triple negative breast cancer is associated with aggressive behavior and high risk of local and regional failure. Aggressive surgical intervention is considered suitable. This makes role of breast conserving therapy (BCT) debatable in these patients. The objective of this study was to compare outcome of BCT for triple negative versus non-triple negative breast cancer. Materials and Methods: Medical records of patients who underwent breast conserving therapy from 1999 to 2009 at Shaukat Khanum Cancer Hospital and had complete receptor status information were extracted. Patients were divided into triple negative breast cancer (TNBC) and non-TNBC. Patient characteristics, medical treatment modalities and adverse events were compared. Expected five year locoregional recurrence free, disease free and overall survival was calculated. The Cox proportional hazard model was used to identify independent predictors of outcome. Results: A total of 194 patients with TNBC and 443 with non-TNBC were compared. Significant difference was present for age at presentation (p<0.0001), family history (p=0.005), grade (p<0.0001) and use of hormonal therapy (p<0.0001). The number of locoregional failures, distant failures and mortalities were not significantly different. No significant difference was present in 5 year locoregional recurrence free (96% vs 92%, p=0.3), disease free (75% vs 74%, p=0.7) and overall survival (78% vs 83%, p=0.2). On multivariate analysis, tumor size, nodal involvement and hormonal treatment were independent predictors of negative events. Conclusions: Breast conserving therapy has comparable outcomes for triple negative and non-triple negative breast cancers.
Keywords
Triple negative breast cancer; breast conservative therapy; outcome;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Rakha EA, Reis-Filho JS, Ellis IO (2008). Basal-like breast cancer: a critical review. J Clin Oncol, 26, 2568-81.   DOI   ScienceOn
2 Voduc KD, Cheang MC, Tyldesley S, et al (2010). Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol, 28, 1684-91.   DOI   ScienceOn
3 Wang J, Xie X, Wang X, et al (2013). Locoregional and distant recurrences after breast conserving therapy in patients with triple-negative breast cancer: a meta-analysis. Surg Oncol, 22, 247-55.   DOI   ScienceOn
4 Zaky SS, Lund M, May KA, et al (2011). The negative effect of triple-negative breast cancer on outcome after breastconserving therapy. Ann Surg Oncol, 18, 2858-65.   DOI
5 O'Brien KM, Cole SR, Tse CK, et al (2010). Intrinsic breast tumor subtypes, race, and long-term survival in the Carolina Breast Cancer Study. Clin Cancer Res, 16, 6100-10.   DOI   ScienceOn
6 Perou CM, Sorlie T, Eisen MB, et al (2000). Molecular portraits of human breast tumours. Nature, 406, 747-52.   DOI   ScienceOn
7 Sharif MA, Mamoon N, Mushtaq S, et al (2010). Steroid hormone receptor association with prognostic markers in breast carcinoma in Northern Pakistan. J Coll Physicians Surg Pak, 20, 181-5.
8 Sidoni A, Cavaliere A, Bellezza G, et al (2003). Breast cancer in young women: clinicopathological features and biological specificity. Breast, 12, 247-50.   DOI   ScienceOn
9 Solin LJ, Hwang WT, Vapiwala N(2009). Outcome after breast conservation treatment with radiation for women with triplenegative early-stage invasive breast carcinoma. Clin Breast Cancer, 9, 96-100.   DOI   ScienceOn
10 Sorlie T, Perou CM, Tibshirani R, et al (2001). Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA, 98, 10869-74.   DOI   ScienceOn
11 Spitale A, Mazzola P, Soldini D, et al (2009). Breast cancer classification according to immunohistochemical markers: clinicopathologic features and short-term survival analysis in a population-based study from the South of Switzerland. Ann Oncol, 20,628-35.   DOI   ScienceOn
12 Van Dongen JA, Voogd AC, Fentiman IS, et al (2000). Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst, 92, 1143-50.   DOI   ScienceOn
13 Li CY, Zhang S, Zhang XB, et al (2013). Clinicopathological and prognostic characteristics of triple-negative breast cancer (TNBC) in Chinese patients: a retrospective study. Asian Pac J Cancer Prev, 14, 3779-84.   DOI   ScienceOn
14 Haffty BG, Yang Q, Reiss M, et al (2006). Locoregional relapse and distant metastasis in conservatively managed triple negative early-stage breast cancer. J Clin Oncol, 24, 5652-7.   DOI   ScienceOn
15 Kwan ML, Kushi LH, Weltzien E, et al (2009). Epidemiology of breast cancer subtypes in two prospective cohort studies of breast cancer survivors. Breast Cancer Res, 11, 31.
16 Millar EK, Graham PH, O'Toole SA, et al (2009). Prediction of local recurrence, distant metastases, and death after breastconserving therapy in early-stage invasive breast cancer using a five-biomarker panel. J Clin Oncol, 28, 4701-8.
17 Lowery AJ, Kell MR, Glynn RW, et al (2012). Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat, 133, 831-41.   DOI
18 Ma KK, Chau WW, Wong CHN, et al (2012). Triple negative status is a poor prognostic indicator in Chinese women with breast cancer: a ten year review. Asian Pac J Cancer Prev, 13, 2109-14.   DOI   ScienceOn
19 Mersin H, Yildirim E, Berberoglu U, et al (2008). The prognostic importance of triple negative breast carcinoma. Breast, 17, 341-6.   DOI   ScienceOn
20 Nielsen TO, Hsu FD, Jensen K, et al (2004). Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res, 10, 5367-74.   DOI   ScienceOn
21 Chu QD, Henderson AE, Ampil F, et al (2012). Outcome for patients with triple-negative breast cancer is not dependent on race/ethnicity. Int J Breast Cancer, 764570.
22 Adami HO, Malker B, Holmberg L, et al (1986). The relation between survival and age at diagnosis in breast cancer. N Engl J Med, 315, 559-63.   DOI   ScienceOn
23 Adkins FC, Gonzalez-Angulo AM, Lei X, et al (2011). Triplenegative breast cancer is not a contraindication for breast conservation. Ann Surg Oncol, 18, 3164-73.   DOI   ScienceOn
24 Dent R, Trudeau M, Pritchard KI, et al (2007). Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res, 13, 4429-34.   DOI   ScienceOn
25 Bauer KR, Brown M, Cress RD, et al (2007). Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California cancer Registry. Cancer, 109, 1721-8.   DOI   ScienceOn
26 Chung M, Chang HR, Bland KI, et al (1996). Younger women with breast carcinoma have a poorer prognosis than older women. Cancer, 77, 97-103.   DOI
27 Dawood S, Broglio K, Kau SW, et al (2009). Triple receptornegative breast cancer: the effect of race on response to primary systemic treatment and survival outcomes. J Clin Oncol, 27, 220-6.   DOI   ScienceOn
28 Fisher B, Anderson S, Bryant J, et al (2002). Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med, 347, 1233-41.   DOI   ScienceOn
29 Freedman GM, Anderson PR, Li T, et al (2009). Locoregional recurrence of triple-negative breast cancer after breastconserving surgery and radiation. Cancer, 115, 946-51.   DOI   ScienceOn
30 Abdulkarim BS, Cuartero J, Hanson J, et al (2011). Increased risk of locoregional recurrence for women with T1-2N0 triple-negative breast cancer treated with modified radical mastectomy without adjuvant radiation therapy compared with breast-conserving therapy. J Clin Oncol, 29, 2852-8.   DOI   ScienceOn
31 Nguyen PL, Taghian AG, Katz MS, et al (2008). Breast cancer subtype approximated by estrogen receptor, progesterone receptor, and HER-2 is associated with local and distant recurrence after breast-conserving therapy. J Clin Oncol, 26, 2373-8.   DOI   ScienceOn