Comparative Study for Clinical Outcomes of Triple-Positive and Triple-Negative Breast Cancer: Long-term Results in 161 Patients Followed in a Single Center

Abstract

Purpose: Triple negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer. However, we have often experienced that triple positive breast cancer (TPBC) shows more aggressive clinical features than TNBC. In this retrospective study, we aimed to examine the differences in clinical courses between TNBC and TPBC. Methods: Using medical records and clinical data, we selected patients with breast cancer who met the criteria for the two groups, TNBC and TPBC, based on the expression or absence of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). We then compared these groups with respect to clinical and pathological variables, such as patient age at diagnosis, TNM stage, number of tumors, involvement of resection margin, operation methods, histologic grade (HG), nuclear grade (NG), and lymphatic invasion (LI). We also compared the disease-free (DFS) and overall survival (OS) outcomes between the groups. Results: Seventy patients with TNBC and 91 with TPBC were identified among a total of 628 patients. In univariate analysis, TPBC was significantly more frequently associated with lower HG (p= 0.001), lower NG (p= 0.003), LI (p= 0.001), and a Ki-67 index ≤ 20% (p< 0.001). In multivariate analysis, a lower Ki-67 index (p= 0.031) and LI (p= 0.022) were identified as significant and independent factors contributing to DFS. In a survival analysis over time, the TPBC showed a worse OS than TNBC 5 years post-treatment for breast cancer. Consequently, the TPBC group had definite worse 10-year DFS (p= 0.012) and showed relatively lower OS rate (p= 0.058), than the TNBC group. Conclusion: Our results demonstrate considerable differences in long-term post-treatment survival of patients with TPBC and TNBC. Further studies to determine the proper management of both types of breast cancer and an accurate prognostic evaluation method are warranted.

Are the Outcomes of Breast Conservation Surgery Inferior to Those of Mastectomy in Patients with Stage II-IIIA Triple-Negative Breast Cancer?

“…In this study, multivariate analyses showed that chemotherapy was not a significant prognostic factor. In addition, the presence of LVI was related to poor prognosis, and this result has further been reported in other studies [14,17,23,24]. Therefore, more intensive treatment should be considered for TNBC patients with LVI.…”

Triple-negative and triple-positive breast cancer cells reciprocally control their growth and migration via the S100A4 pathway

“…Patients with S100A4-positive tumors have inferior metastasis-free and overall survival compared to S100A4-negative. S100A4-expression was strongly associated with triple-negative subtype, metastasis-free and overall survival was numerically reduced in patients with S100A4-positive tumors [ 5 ]. However, sometimes TPBC shows more aggressive clinical features than TNBC.…”

Ca2+ Signaling as the Untact Mode during Signaling in Metastatic Breast Cancer

“…Genotypic or phenotypic heterogeneity of breast cancer is diverse. While triple-negative breast cancer generally has the most aggressive behavior and poor clinical outcomes [ 18 , 19 , 20 ], triple-positive breast cancer has also been found to exhibit aggressive behavior, despite the availability of antibody-targeted therapy or chemotherapy [ 21 ].…”