Triple negative breast cancer (TNBC) is a distinct subtype of breast cancer with unique pathological, molecular and clinical behaviour. There are no approved targeted treatments for TNBC other than chemotherapy. Our aim is to study the clinicopathological characteristics and outcomes of TNBCs in Indians and to compare them with that of the West.
Data of 1024 breast cancer patients registered at our institute between 2009 and 2014 was retrospectively analyzed and the ones with TNBC were identified. Relevant Demographic and clinical information was collected. Survival data was analyzed using the GraphPad Prism 6 Software.
A total of 210 TNBC’s were identified which accounted for 20.5% of all breast cancers. Median age at diagnosis was 50years(22-78years). Ninety six patients (46%) had lump in the breast of less than 3 months duration. Family history of breast or ovarian cancer was present in 6 patients. Ninety five patients (45%) were pre or perimenopausal at presentation. At the time of diagnosis 117 patients (55%) had early breast cancer, 84 patients (40%) had locally advanced breast cancer and only 9 patients (4%) had metastatic disease. Nodal involvement was seen in 131 patients (62%). Modified Radical Mastectomy was the preferred surgery by most patients, who were eligible for upfront surgery (81%). Most of the tumors were Grade 3 (78%). Lymphovascular invasion and margin positivity was present in 18% and 4% of the tumors respectively. Anthracyclines and taxanes were used in the adjuvant treatment of majority of patients. Adjuvant chemotherapy was administered for 179 patients (85%) and Neoadjuvant chemotherapy for 22 (11%) patients. Pathological Complete Response was obtained in 60% of patients. During the 3 year follow up period 59 patients (33%) had recurrences, the most common sites being lung (in 21 patients) followed by bone and brain. Three year OS was 63%, Event Free Survival was 57%. Sixty six patients died during this period and 32 were lost to follow up.
TNBC’s are aggressive malignancies. The 3year OS in our study is less than that in the West (63% vs 70%). Inspite of the initial chemoresponsiveness systemic relapses are high within the first 3 years of diagnosis which warrants further studies on intensification of chemotherapy in Indian patients.
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All authors have declared no conflicts of interest.