Clinicopathological Features And Prognosis For Triple-negative Breast Cancer

Purpose: To compare the clinicopathological feature and prognosis for women with triple-negative breast cancer with women with other kinds of breast cancer.Methods: We studied a cohort of 302 patients with breast cancer, diagnosed between December 2005 and December 2009 with complete data at The First Affiliated hospital of Anhui Medical University. The patients were divided into triple-negative group and non-triple-negative group, and their clinicopathological features and prognosis significance such as DFS and OS were explored.Results: The median follow-up time of the 302 patients was 52 months. Seventy-four of 302 patients (24.50%) had triple-negative breast cancer. Compared with non-triple-negative breast cancer patients, triple-negative patients were more younger when diagnosis(48.5:50.1)and premenopausal women made the majority(60.8%), and they have greater tumor size(4.0:3.5cm, P<0.05), T3 takes in a large part(24.3%:13.1%,P=0.022),moreover, grade 3 accounts for more than 50%(66%:23%, P<0.001). Mainly invasive ductal carcinoma in pathological types, higher Histological tumor grade and lymph node positive rate(59.5%:44.3%, P=0.023). In addition, the tumor size has no significant relationship with lymph node conditions. They also have worse prognosis, 1~4-year-disease free survival (DFS) and overall survival (OS) rate are both lower than non-triple-negative breast cancer patients. DFS in the first 4years are as follows: TNBC 85.1%(1y), 71.6%(2y), 59.5%(3y), 58.1(4y);Non-TNBC 89.9%(1y), 82.9%(2y), 75.9%(3y), 71.9(4y); OS in the first 4years are as follows: TNBC 90.5%(1y), 83.8%(2y), 75.7%(3y), 71.6(4y);Non-TNBC:96.9%(1y), 94.3%(2y), 89.5%(3y), 85%(4y). TNBC has a higher rate to progress(43.2%:30.3%, P=0.04), and a higher rate of metastasis(37.8%:20.2%, P<0.0001), especially in visceral metastasis(27.0%:13.2%, P=0.005)and brain metastasis(16.2%:7.5%, P=0.026), but there are no significant difference in local recurrence(13.5%:11.8%, P=0.703)and bone metastasis(10.8%:10.1%, P=0.859). In the follow-up 23patients died of cancer in TNBC, and 41 patients in Non-TNBC .the time from recurrence to death is 9 months in TNBC versus 18 months in Non-TNBC. In triple-negative group, the risk of recurrence peaked within three years after diagnosis while in non-triple-negative group, the risk of recurrence is stable in follow up.Conclusions: Triple-negative breast cancers have a more aggressive clinical course. triple-negative patients were more younger when diagnosis and premenopausal women made the majority; and the size of tumors have no significant relationship with lymph node conditions, although TNBC patients have a much larger tumor size and higher Histological tumor grade. It is more feasible to have visceral and brain metastasis. The risk of recurrence peaked at 1~3 years after operation.