Breast cancer (BC) is the most common cancer in India with 150000 new cases are diagnosed and 70000 women dies of it every year. Triple-negative breast cancer (TNBC) is an aggressive subtype that lack ER and PR expression and absence of overexpressed or amplified HER2. TNBC accounts for 15%-25% of all invasive BC, occurs more in younger women and is associated with higher histologic grade and advanced disease. Our goal was to study the relation between triple-negative receptor status and major determinants of clinical outcome, such as response to neoadjuvant chemotherapy (rate of pathologic complete response [pCR]), progression free survival (PFS), site-specific distribution of recurrence, postrecurrence survival (PRS) and overall survival (OS).
We included 2658 patients who received neoadjuvant chemotherapy at Jawaharlal Nehru Cancer Hospital Bhopal for stage I-III breast cancer from 1990 to 2010 and for whom complete receptor information were available. Clinical and pathologic parameters, pCR, survival measurements and organ-specific relapse rates were compared between patients with TNBC and non-TNBC.
505 patients (19%) had TNBC. Mean age for TNBC (42 years) was lesser than non-TNBC (56 years; P=.002). Patients with TNBC had significantly higher pCR rates (34% v 14%; P=.028) but decreased 5 year PFS rates (P
TNBC patients have increased pCR rates (excellent survival) compared with non-TNBC. However TNBC patients with RD have significantly worse survival after neoadjuvant chemotherapy in first 5 years.TNBC patients may be best treated with 3rd generation adjuvant or neoadjuvant chemotherapy regimens that achieve the highest possible pCR rates. With high risk of distant metastases, these patients require closer surveillance in initial years of follow-up.
Clinical trial identification
Legal entity responsible for the study
Jawaharlal Nehru Cancer Hospital, Bhopal, India
All authors have declared no conflicts of interest.