Locoregional Recurrence in Patients With Triple-Negative Breast Cancer

Dragun, Anthony E.; Pan, Jianmin; Shesh, N.; Kruse, Barbara; Jain, Dharamvir

doi:10.1097/coc.0b013e3181dea993

Cited by 38 publications

(20 citation statements)

References 14 publications

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“…Our data are comparable with data from Dragun et al,16 who investigated the influence of PORT in TNBC patients after BCS. In this study, 53 patients (69%) received PORT.…”

Section: Discussionsupporting

confidence: 91%

Locoregional recurrence of triple-negative breast cancer: effect of type of surgery and adjuvant postoperative radiotherapy

Bayoumi¹,

AbdelSamie²,

Abdelsaid³

et al. 2014

BCTT

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Background/purposeThe aim was to evaluate the prognostic significance of postoperative radiotherapy (PORT) and surgical type on local recurrence-free survival (LRFS) and overall survival (OS) in triple-negative breast cancer (TNBC) in the Egyptian population.Patients and methodsWe evaluated 111 patients with stage I–III TNBC diagnosed at our institute during the period from 2004 to 2009. Patients were stratified according to PORT into two groups: a PORT group and a non-PORT group. The influence of PORT and surgical type on LRFS and OS were evaluated. A cross-matching was done to the non-TNBC group of patients to compare the recurrence and survival rates between them and the studied group of TNBC patients.ResultsThe mean age of TNBC patients at diagnosis was 63±7 years. The majority of the patients had stage III disease (68.5%) and 73% had clinical or pathological positive lymph nodes. Sixty percent (67/111) of patients had modified radical mastectomy and 44/111 (40%) patients had breast-conserving treatment. PORT was given for 63% of patients, while systemic treatment was given in 89% of patients. At the time of analysis, 13 patients (11%) developed local recurrence: five of 70 (7%) in the PORT group and eight of 41 (19.5%) in the non-PORT group. Five-year LRFS for the whole group of patients was 88%±6%, which was significantly affected by PORT. The surgical type did not affect local recurrence significantly. Five-year OS for the whole group was 54%±8%. PORT and surgical type did not affect OS significantly (P-value 0.09 and 0.11, respectively). Five-year LRFS was 88%±6% and 90%±11% for TNBC and non-TNBC patients, respectively (P-value 0.8); however, OS for TNBC was significantly lower than for non-TNBC (P-value 0.04).ConclusionTNBC is an aggressive entity compared with other non-TNBC, and these patients benefit from PORT significantly to decrease the risk of local recurrence in all stages. However, further large, prospective, randomized trials are warranted.

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“…Our data are comparable with data from Dragun et al,16 who investigated the influence of PORT in TNBC patients after BCS. In this study, 53 patients (69%) received PORT.…”

Section: Discussionsupporting

confidence: 91%

Locoregional recurrence of triple-negative breast cancer: effect of type of surgery and adjuvant postoperative radiotherapy

Bayoumi¹,

AbdelSamie²,

Abdelsaid³

et al. 2014

BCTT

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“…However, the radiation group had a higher probability of locoregional-free survival after three years (13). Abdulkarim et al found that T1-2N0 TNBC patients treated with MRM without RT had a significantly increased risk of locoregional recurrence in comparison with those treated with BCT, but there was no difference in overall survival (9).…”

Section: Discussionmentioning

confidence: 99%

Impact of radiation therapy on survival in patients with triple-negative breast cancer

et al. 2013

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Triple-negative breast cancer (TNBC) has a poorer prognosis compared with other sub-groups. In the current study, survival associated with locoregional treatment of females with TNBC was investigated. Specifically, 468 patients with stage I–III TNBC treated between 2002 and 2009 were identified. Data included patient and tumor characteristics, treatment received and survival. Data were compared using χ2 and Fisher’s exact tests, as well as MANOVA. Kaplan-Meier curves were generated. The study cohort had a mean age of 54±13 years old with a mean follow-up period of 51±21 months. Of 468 patients, 249 (53%) underwent lumpectomy, 63 (14%) underwent simple mastectomy (SM) and 156 (33%) underwent modified radical mastectomy (MRM). Overall, 263 (56%) received adjuvant radiation, including 178/249 (71%) following lumpectomy, 13/63 (21%) following SM and 72/156 (46%) following MRM (P<0.0001). Following control for potential confounders in univariate tests, adjuvant radiation was associated with improved overall survival in the total cohort (HR, 0.46; 95% CI, 0.31–0.68; P=0.0001). When comparing survival by surgical type, receipt of adjuvant radiation significantly improved survival in the lumpectomy group (HR, 0.30; 95% CI, 0.16–0.58; P=0.0004), but was not associated with improved survival in the SM group (HR, 0.38; 95% CI, 0.05–3.04; P=0.36) or in the MRM group (HR, 0.79; 95% CI, 0.46–1.34; P=0.38). The survival benefit of adjuvant radiation in these TNBC patients is attributed to those undergoing breast-conserving therapy. There was no benefit in either mastectomy group. These data warrant validation from prospective trials, in order to develop tailored locoregional treatment for patients with TNBC.

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“…29,30 Recent reports have suggested that this improvement also extends to patients with TNBC. 31,32 The time range included in the current cohort reflects an era during which attitudes about and indications for postmastectomy radiotherapy have been in evolution, including within our institution. As such, the group studied may not accurately reflect the impact of such therapy on LRR as managed by current protocols.…”

Section: Discussionmentioning

confidence: 99%

Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation

et al. 2011

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Background Triple-negative breast cancer (TNBC) is an aggressive subtype shown to have a high risk of locoregional recurrence (LRR). The purpose of this study was to determine the impact of operation type on LRR in TNBC patients. Methods A total of 1325 patients with TNBC who underwent breast-conserving therapy (BCT) or mastectomy from 1980 to the present were identified. Clinical and pathological factors were compared by the chi-square test. LRR-free survival (LRRFS), distant metastasis-free survival, and overall survival were estimated by the Kaplan–Meier method. Multivariate analysis was performed by the Cox proportional hazard models. Results BCT was performed in 651 patients (49%) and mastectomy in 674 (51%). The mastectomy group had larger tumors, a higher incidence of lymphovascular invasion, and higher pathologic N stage (all P < 0.001). At 62-month median follow-up, LRR was seen in 170 (26%) in the BCT group and 203 (30%) in the mastectomy group. Five-year LRRFS rates were higher in the BCT group (76% vs. 71%, P = 0.032), as was distant metastasis-free survival (68% vs. 54%, P < 0.0001) and overall survival (74% vs. 63%, P < 0.0001). On multivariate analysis, T stage (hazard ratio [HR] 1.37, P = 0.006), high nuclear grade (HR 1.92, P = 0.002), lymphovascular invasion (HR 1.93, P < 0.0001), close/positive margins (HR 1.89, P < 0.0001), and use of non–anthracycline or taxane-based adjuvant chemotherapy (HR 2.01, P < 0.0001) increased the LRR risk, while age >50 years was protective (HR 0.73, P = 0.007). Operation type (mastectomy vs. BCT, HR 1.07, P = 0.55) was not statistically significant. Conclusions BCT is not associated with increased LRR rates compared to mastectomy. TNBC should not be considered a contraindication for breast conservation.

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Locoregional Recurrence in Patients With Triple-Negative Breast Cancer

Abstract: Despite significantly lower AJCC stage, patients with triple-negative breast cancer who do not undergo radiotherapy have a significantly higher risk of locoregional recurrence.

Cited by 38 publications

References 14 publications

Locoregional recurrence of triple-negative breast cancer: effect of type of surgery and adjuvant postoperative radiotherapy

Locoregional recurrence of triple-negative breast cancer: effect of type of surgery and adjuvant postoperative radiotherapy

Impact of radiation therapy on survival in patients with triple-negative breast cancer

Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation

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