258P - Prognostic factors in early-stage triple negative breast cancer (TNBC): the limits of clinical and pathological features

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Breast Cancer, Early Stage
Pathology/Molecular Biology
Presenter Nicolas Pecuchet
Authors N. Pecuchet1, M. Le Frère Belda2, T. Popovski3, S. Haouas1, F. Chamming'S4, F. Lécuru5, S. Oudard6, J. Medioni1
  • 1Dept. Medical Oncology, Hopital European George Pompidou, 75015 - Paris/FR
  • 2Dept. Pathology, Hopital European George Pompidou, 75015 - Paris/FR
  • 3Gynecology, Necker University Hospital, Paris/FR
  • 4Dept. Radiology, Hopital European George Pompidou, 75015 - Paris/FR
  • 5Dept. Gynecologic Surgery, Hopital European George Pompidou, 75015 - Paris/FR
  • 6Medical Oncology Service, Hopital European George Pompidou, 75015 - Paris/FR

Abstract

Background

Triple negative breast cancer (TNBC) patients (pts) is an heterogeneous population regarding prognostic. Therefore, clinical and histological features were evaluated in a large monocenter cohort of patients treated for localized TNBC to identify good-prognostic TNBC.

Methods

All consecutive early-stage TNBC (ER 0%, PR 0%, HER2 neg) patients treated at European Georges Pompidou Hospital, Paris, France, between 2000 and 2011 were included. Records were reviewed for demographic, clinical and pathological data. Prognostic factors were determined using univariate and multivariate stepwise log-rank analysis on disease-free survival (DFS) and overall survival (OS).

Results

This analysis included 128 women with early-stage TNBC. Clinical and histological characteristics are summarized below. After a median follow-up of 37 months 36 relapses and 19 deaths were observed. The 3-years recurrence rate was 30% (95%CI 22-40) in the whole population. For DFS, bad prognostic factors in univariate analysis were: large tumor size (T3-4), node involvement (N1-3), node capsular effraction, lymphovascular invasion (LVI) and high grade (SBR 2-3). Multivariate analysis identified tumor size (T3-4) (HR 3.70, 95%CI 1.61-8.52) and LVI (HR 2.87, 95%CI 1.39-5.93) as independent factors. The 3-years recurrence rate remained high (20%, 95%CI 10-34) in patients with two good prognostic factors (T0-2 and no LVI). For OS, bad prognostic factors significant in univariate and multivariate analysis were: node capsular effraction (HR 3.57, 95%CI 1.17-10.92) and LVI (HR 3.43, 95%CI 1.18-9.92).

Conclusions

In this early-stage TNBC series, LVI was a bad prognostic factor of relapse and death. However, the 3-years recurrence rate remained high in patients with good prognostic features. Therefore, new biomarkers are mandatory for a better stratification of this heterogeneous population.

Clinical and histological characteristics

N (128pts) %
Median age (yrs) 56 range 22-88
Histological type
Invasive ductal carcinoma 123 96
Invasive lobular carcinoma 5 4
Tumor stage
T0-T2 105 82
T3-T4 23 18
Node stage
N0 97 76
N1-3 31 24
Node capsular effraction
pos 14 11
neg 111 87
NE 3 2
Tumor grade (SBR)
1 8 6
2-3 107 84
NE* 13 10
Lymphovascular invasion (LVI)
pos 34 27
neg 74 58
NE** 20 16

*Due to neoaduvant chemotherapy **Due to small biopsies.

Disclosure

S. Haouas: Grant from Association pour la Recherche en Thérapeutiques Innovantes en Cancérologie (ARTIC).

All other authors have declared no conflicts of interest.