Determinants of Prognosis in Triple-Negative Breast Cancer: Report from a Large Breast Cancer Registry

Abstract

Background: The outcome of patients with triple-negative breast cancer (TNBC) is highly dependent on demographic factors and ethnicity. We aimed to evaluate the clinicopathological determinants of prognosis among women with TNBC using data from one of the largest breast cancer (BC) registries. Methods: A total of 6145 patients with BC from our referral center were evaluated from 1995 to 2018, among whom 523 had TNBC. The baseline, menstrual and reproductive, treatment and pathology related characteristics were evaluated. Results: Among TNBC patients, the rate of stage 3 and 4 BC (29.9% vs. 14.4% and 7.8% vs. 0% for stage 3 and 4, respectively; P < 0.001), invasive ductal carcinoma (90.7% vs. 75.6%; P = 0.004), nodal involvement (46.7% vs. 33.4%; P = 0.026), mastectomy (57.3% vs. 37.8%; P = 0.001) and axillary node dissection (76.7% vs. 59.8%; P = 0.019) was significantly higher in the group that developed recurrence. Disease-free-survival was 80.6% (157.76 ± 9.48 months) and overall-survival was 90.1% (182.73 ± 3.28 months). For death, stage 3 BC (compared to stages 0 and 1 as base) showed a higher risk of earlier death (adjusted HR: 4.191, 95% CI = 1.392-12.621; P = 0.011). For recurrence, stage 3 BC (adjusted HR: 1.044, 95% CI = 1.209-6.673; P = 0.017) (compared to stages 0 and 1 as base) showed significantly higher risk for developing earlier recurrence. Moreover, those who had invasive ductal carcinoma (compared to other types of BCs) had a higher risk for developing earlier recurrence (adjusted HR: 3.307, 95% CI = 1.191-0.724; P = 0.012). Conclusion: BC stage plays a significant role in both earlier recurrence and earlier mortality among patients with TNBC.