Predictive Factors and Patterns of Recurrence in Patients with Triple Negative Breast Cancer

Steward, Lauren; Conant, Leah; Gao, Feng; Margenthaler, Julie A.

doi:10.1245/s10434-014-3546-4

Cited by 62 publications

(60 citation statements)

References 23 publications

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“…In addition to subtype-specific recurrence patterns, risk factors for recurrence, such as increasing tumor size, positive nodal status, lymphovascular invasion, increasing stage, and type of chemotherapy (adjuvant vs neoadjuvant), were also observed in a cohort of patients with triple-negative breast cancer (12)(13)(14). Most of these previous studies, however, included locally advanced triple-negative cancer, and factors associated with recurrence in patients with early stage (ie, stage I or II) triple-negative breast cancer have not yet been described.…”

Section: Preoperative Imaging and Patient Treatmentmentioning

confidence: 99%

Early Stage Triple-Negative Breast Cancer: Imaging and Clinical-Pathologic Factors Associated with Recurrence

Bae¹,

Moon²,

Han³

et al. 2016

Radiology

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).q RSNA, 2015 Purpose:To determine the imaging and clinical-pathologic factors associated with recurrence in patients with early stage triple-negative breast cancer. Materials and Methods:This study was approved by the institutional review board, and the requirement to obtain informed consent was waived. Results:Of the 398 patients, 63 (15.8%) had recurrent disease after a median follow-up of 6.1 years. The absence of preoperative MR imaging (hazard ratio [HR] with multivariate analysis = 2.66; 95% confidence interval = 1.49, 4.75; P , .001), dense breast tissue (HR = 2.77; 95% confidence interval = 1.39, 5.51; P = .004), family history of breast cancer (HR = 2.32; 95% confidence interval = 1.10, 4.90; P = .028), and lymphovascular invasion (HR = 1.83; 95% confidence interval = 1.11, 3.03; P = .019) were found to be independently associated with recurrence. These same factors were also found to be associated with recurrencefree survival. Conclusion:The absence of preoperative MR imaging and the presence of dense breast tissue at mammography were associated with an increased risk of recurrence in patients with triple-negative breast cancer.q RSNA, 2015

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Section: Preoperative Imaging and Patient Treatmentmentioning

confidence: 99%

Early Stage Triple-Negative Breast Cancer: Imaging and Clinical-Pathologic Factors Associated with Recurrence

Bae¹,

Moon²,

Han³

et al. 2016

Radiology

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“…Accumulating studies have focused on nodal status as one of the most crucial prognostic factors in breast cancer patients [10–12]. For instance, nodal status has been associated with overall prognosis [13, 14]. However, other studies did not confirm the prognostic significance of nodal status in TNBC [15, 16].…”

Section: Introductionmentioning

confidence: 99%

Effect of nodal status on clinical outcomes of triple-negative breast cancer: a population-based study using the SEER 18 database

Wang

Jiang

et al. 2016

Oncotarget

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Triple-negative breast cancer (TNBC) is an aggressive malignancy with a poor prognosis. Data from the Surveillance, Epidemiology and End Results database (2010–2012) were used to identify 10,771 patients with TNBC, and we assessed the effects of lymph node (LN) status on breast cancer-specific survival (BCSS) and overall survival (OS). In our study, a Kaplan-Meier plot showed that LN-negative patients (N0) had better survival outcomes than LN-positive patients and that patients with ≥10 positive LNs (N3) exhibited the worst survival outcomes regardless of tumor size. A pairwise comparison showed no difference in survival outcomes among each group stratified by tumor size. Further, for LN-positive patients with a tumor size ≤2 cm (T1) or >5 cm (T3), there were similar outcomes between patients with one to three LNs (N1) and those with four to nine LNs (N2), whereas N1 patients experienced significantly better survival outcomes than N3 patients (P<0.001). Therefore, ten metastatic lymph nodes was the cut-off value for poor prognosis. Nevertheless, for patients with a tumor size of 2-5 cm (T2), the extent of LN involvement contributed prognostic value to OS but not BCSS. In summary, we found that nodal status and tumor size exhibited distinct interaction patterns for predicting the outcomes of TNBC. These results provide deeper insight into the prognostic value of nodal status in TNBC.

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“…[36][37][38] In general, TNBC is associated with a poor prognosis of increased relapse and decreased OS. 39 At present, there is no targeted therapy available for TNBC. Cytotoxic chemotherapy, specifically anthracycline-and taxanebased regimens, remains as the current standard.…”

Section: Neoadjuvant Therapy For Early-stage High-risk Breast Cancermentioning

confidence: 99%

Neoadjuvant Chemotherapeutic and Targeted Therapies for Early-stage, High-risk Breast Cancer

Chung¹,

Lee²

2014

European Oncology &Amp; Haematology

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Neoadjuvant or preoperative chemotherapy is the preferred treatment for locally advanced, inflammatory and early-stage high-risk breast cancers. Patients with locally advanced breast cancers are candidates for neoadjuvant therapy because their tumours are often not amenable to resection. On the other hand, patients are candidates for neoadjuvant chemotherapy if the breast-conserving surgery is not possible. At present, anthracycline-and taxane-based chemotherapy regimens remain as the cornerstone for neoadjuvant therapy in early breast cancer, but there is a clear need for effective therapies in high-risk, early-stage patients. A number of chemotherapeutic and targeted therapies have been evaluated in clinical trials with varying results. The US Food and Drug Administration (FDA) has recently approved pertuzumab in combination with trastuzumab and cytotoxic chemotherapy as a neoadjuvant therapy option for HER2-positive breast cancer. This article reviews the neoadjuvant chemotherapeutic and targeted therapies options for early-stage, high-risk breast cancer. Possible role of molecular subtyping in triple-negative breast cancer is also described. KeywordsNeoadjuvant, triple-negative, locally advanced, inflammatory, breast cancer, HER2, molecular subtyping Neoadjuvant therapy (also referred to as preoperative, pre-surgical, induction or primary systemic therapy) is the systemic treatment of breast cancer in the preoperative setting with curative intent. It was first evaluated more than 30 years ago for the treatment of locally advanced, inflammatory (a subtype of locally advanced breast cancer) and inoperable breast cancers.3 It is now increasingly used in patients with operable disease.3 The primary objective of the neoadjuvant therapy is to improve surgical outcomes 3-5 in patients for whom a primary surgical approach is technically not feasible and in patients with operable breast cancer who desire breast conservation. Second, neoadjuvant therapy decreases the need for complete axillary lymph node dissection.6-8 It also allows an early evaluation of the systemic therapy. Third, neoadjuvant therapy gives clinicians an opportunity to obtain tumour specimens prior to and during the preoperative treatment, thus enabling researchers to investigate emerging drug therapies and predictive biomarkers. 7,8 Recently, following the announcement by the US Food and Drug Administration (FDA) 9 that it will consider neoadjuvant randomised trials for accelerated drug approval in early breast cancer, there has been a marked increase in clinical trials with novel agents in the neoadjuvant setting. This review focuses on the current and emerging neoadjuvant chemotherapies and targeted therapies for early-stage, high-risk 9 (defined as 20-25 % risk of recurrence or death at 5 years) breast cancer. Patient SelectionNeoadjuvant chemotherapy is the preferred treatment for locally

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Predictive Factors and Patterns of Recurrence in Patients with Triple Negative Breast Cancer

Cited by 62 publications

References 23 publications

Early Stage Triple-Negative Breast Cancer: Imaging and Clinical-Pathologic Factors Associated with Recurrence

Early Stage Triple-Negative Breast Cancer: Imaging and Clinical-Pathologic Factors Associated with Recurrence

Effect of nodal status on clinical outcomes of triple-negative breast cancer: a population-based study using the SEER 18 database

Neoadjuvant Chemotherapeutic and Targeted Therapies for Early-stage, High-risk Breast Cancer

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