Abstract 262P
Background
Triple-negative subtype accounts for 12-16% of all breast cancer cases, tends to occur at younger age, and presents aggressively with rapid progression and poor survival.
Methods
We retrospectively reviewed breast cancer patients’ files to define triple-negative breast cancer (TNBC) patients’ characteristics, prognostic factors, treatment modalities, pattern of recurrence and survival outcomes.
Results
965 breast cancer cases were identified. 147 patients had TNBC with an incidence of 15.2%. 19 patients were excluded with final analysis of 128 TNBC patients. 71.1% of patients were premenopausal with median age of 43 years. T2, T3, T4 tumors represented 46.1%, 32% and 14.1%, respectively. N0, N1, N2, N3 disease represented 18.5%, 50.9%, 27.8% and 2.8%, respectively. Stages II, III& IV constituted 34.1%, 44.2 % and 15.5%, respectively. 83.6% patients had IDC and 61.7% had G3 tumors. 31.5% patients received neoadjuvant chemotherapy with 17.7% complete pathological response rate. 65.7% patients had modified radical mastectomy (MRM) while 34.3% had breast-conserving surgery (BCS). 19.5%, 35.9%, 44.6% patients had unknown, ≤20 and >20 Ki67, respectively. Non-metastatic patients (n=108) had median follow up duration of 3.5 years. 21.3% patients developed relapse and 91.3% of them relapsed 6 – 24 months after diagnosis with median time to relapse of 11 months. 78.3% of relapsed patients had visceral (88.3% lung) metastasis, 13% bone metastasis, 21.7% brain metastasis and 13% locoregional recurrence (LRR). Significantly high risk of relapse in patients with large tumor size [T4: 66.75%, T3: 22.9%, T2:16.7%, T1: 0% (p= 0.002)], positive LNs [N3: 100%, N2: 37.9%, N1: 15.1%, N0: 4.3% (p <0.001)] and Ki67 [> 20: 31.6% versus 10.8% for Ki67≤ 20 (P =0.007)]. Multivariate analysis revealed only T4 and N2-3 were significantly associated with high probability for relapse (P = 0.022 and 0.038, respectively). The 3-year DFS and OS were 75.9% and 78.7%, respectively. For metastatic patients, the median follow up duration was16 months with median PFS of 7 months, median OS of 1.5 years. For the whole study patients, the 3-year OS was 64.1%. The 3-year OS for stages I, II, III and IV were 100%, 79.5%, 73.7% and 0 %, respectively (P= < 0.001).
Conclusions
Our data confirms the aggressive nature of TNBC with significant risk of relapse for T4, N2-3 and poor survival for relapsed patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Sherif Farouk Elzawawy.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.