The Clinicopathologic Features And Outcomes Of Triple-positive Breast Cancer

Purpose Each molecular subtype of breast cancer is different in prognosis andtreatment options. However the main aims in our study were to investigate theclinicopathologic features and outcomes of triple-positive breast cancer (TPBC).Methods Complete clinicopathologic data and follow-up data of a total of865patients with invasive breast cancer were analyzed. Immunohistochemical (IHC)markers for estrogen receptor (ER), progesterone receptor (PR), Her2/neu, andKi-67proliferation index were used to classify cases into five molecular subtypes.The clinicopathologic features and outcomes of TPBC were analyzed by somestatistical methods compared to the other four subtypes.Results Of all the patients,9.1%were TPBC. The patients with triple-positivesubtype had significantly younger age, higher grade, more lymphovascular invasionand more LN-positive status than those with Luminal A subtype (P<0.05), whereasthere was no significant difference compared to those with luminal B(high Ki67)subtype(P>0.05). Multivariate logistic regression revealed size, age at diagnose(<35year), lymphovascular invasion and molecular subtype (mainly being triple-positive)to be independent predictors of LN involvement. The rate of metastasis with morethan two sites was mainly in the cases of recurrence and metastasis withtriple-positive subtype. Luminal A subtype had the best survival, closely followedby Luminal B(high Ki-67). However the DFS and OS curve for patients with triple-positive were significantly lower than those with Luminal A (P=0.004andP=0.024, respectively). The HER2-enriched subtype and Tripe-negative had thepoorest prognosis, but the OS curve of triple-positive subtype was not significantlyhigher than that of HER2-enriched subtype (P=0.067).Conclusions Triple-positive subtype is more likely LN positive, has a worseoutcome than other ER+subtype in the luminal group and is hard to derivesignificant benefits from endocrine therapy in determining survival.