Abstract 2698
Background
Triple negative breast cancers are a heterogeneous group of breast cancer candidate to adjuvant chemotherapy in a large majority of cases. However, literature data indicate that the diagnosis of special types of breast cancer might be associated with a different outcome if compared with invasive ductal carcinoma with similar biological features and stages. Selected triple negative apocrine breast cancer can have an extremely good prognosis.
Methods
Among the 210 women with first primary invasive apocrine non metastatic breast cancer operated between January 1998 and December 2016 at European Institute Oncology, Milan, we identified 24 patients with pT1-pT2, node-negative, triple negative subtype and Ki-67 ≤20% who did not receive adjuvant chemotherapy. We compared the outcome of this cohort with a similar group of 48 patients with ductal tumors who received adjuvant chemotherapy, matched by pathological stage and biological features (matching ratio 1:2).
Results
The median age was 63 and 50 years in the apocrine and ductal group, respectively. The mean value of Ki-67 expression was 12% in the apocrine group and 14% in the ductal group. 83% of apocrine tumors had size less than 2 cm, compared with 71% of ductal tumors. After a median follow-up of 6.6 years no patients in the apocrine group experienced a breast cancer related event compared with 12 events (including 5 loco-regional recurrences, 3 distant recurrences e 4 contralateral tumors) in the ductal carcinoma group (Gray test p-value=0.015).
Conclusions
The outcome of selected apocrine triple negative breast cancer patients is excellent and possibly deserves a treatment de-escalation. Multicenter projects focusing on the possibility to avoid adjuvant chemotherapy in selected subtypes of triple negative breast cancers with favorable outcome are warranted.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
G. Cancello: Honoraria (self): Pierre Fabre. E. Montagna: Honoraria (self): Pierre fabre; Honoraria (self): gentili. E. Munzone: Honoraria (institution), Advisory / Consultancy: Pierre Fabre; Honoraria (institution), Advisory / Consultancy: Genomic Health. S. Dellapasqua: Travel / Accommodation / Expenses: Roche. M.A. Colleoni: Advisory / Consultancy: Pierre Fabre; Advisory / Consultancy: Pfizer; Advisory / Consultancy: OBI Pharma; Advisory / Consultancy: Puma Biotechnology; Advisory / Consultancy: Celldex; Advisory / Consultancy: AstraZeneca. All other authors have declared no conflicts of interest.
Resources from the same session
1849 - Effect of thioredoxin 1 quantity detection to complement the mammography in breast cancer diagnosis
Presenter: Younju Lee
Session: Poster Display session 2
Resources:
Abstract
2221 - Identification of ultralow risk breast cancer patients (probable overdiagnosis)
Presenter: Salvador Gamez Casado
Session: Poster Display session 2
Resources:
Abstract
5291 - Prevalence of Vitamin D3 deficiency among women with early breast cancer receiving chemotherapy in an oncology dayward.
Presenter: Warner Finstad
Session: Poster Display session 2
Resources:
Abstract
4247 - Changes in ER pathway activity score during neoadjuvant letrozole to assess therapy response and predict disease free survival (DFS) in ER positive breast cancer patients
Presenter: Arran Turnbull
Session: Poster Display session 2
Resources:
Abstract
568 - Second primary malignancies in patients with breast cancer.
Presenter: Carlos Erasun Lecuona
Session: Poster Display session 2
Resources:
Abstract
1428 - Phase II randomized trial of neoadjuvant trastuzumab and pertuzumab (TP) with either palbociclib + letrozole (Pal+L) or paclitaxel (Pac) for elderly patients with estrogen receptor & HER2 positive (ER+/HER2+) Breast Cancer (BC) (International Breast Cancer Study Group IBCSG 55-17, TOUCH)
Presenter: Laura Biganzoli
Session: Poster Display session 2
Resources:
Abstract
1479 - Neoadjuvant HER2-targeted therapy with or without immunotherapy with pembrolizumab (neoHIP): an open label randomized phase 2 trial
Presenter: Heather McArthur
Session: Poster Display session 2
Resources:
Abstract
1481 - A randomized phase 2 study of peri-operative ipilimumab, nivolumab and cryoablation versus standard care in women with residual, early stage/resectable, triple negative breast cancer after standard-of-care neoadjuvant chemotherapy
Presenter: Heather McArthur
Session: Poster Display session 2
Resources:
Abstract
4334 - ALEXANDRA/IMpassion030: A phase 3 study of standard adjuvant chemotherapy with or without atezolizumab in early stage triple negative breast cancer.
Presenter: Michail Ignatiadis
Session: Poster Display session 2
Resources:
Abstract
2107 - Role of Individualized Intervention(s) on Quality of Life (QOL) and Adherence to Adjuvant Endocrine Therapy in Premenopausal Women with Early-Stage Breast Cancer (BC): MyChoice Study
Presenter: Shahid Ahmed
Session: Poster Display session 2
Resources:
Abstract