Risk factors for distant metastasis of patients with primary triple-negative breast cancer

Abstract

Objective: Triple-negative breast cancer (TNBC) involves higher rates of recurrence and distant metastasis. The present study sought to characterize the risk factors for distant metastasis of TNBC. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was exploited to enroll patients diagnosed with TNBC from 2010 to 2015. The eligible patients were dichotomized into locoregional and distant metastasis at the time of diagnosis. Patients’ demographics and tumor features, and treatment were evaluated to identify the risk factors for distant metastasis of primary TNBC. The categorical variables were examined by chi-square tests. Univariate and multivariate logistic regression analyses were used to determine the risk factors for distant metastasis. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated by Kaplan–Meier plots with log-rank tests. Results: We collected 26863 patients with primary TNBC, 1330 (5.0%) of them presented with distant metastasis. In the univariate analysis, all the variables indicated statistical significance. The significant variables were subsequently enlisted into the multivariate logistic regression analysis. Age > 50, higher clinical stage T and N, and tumor size > 5 cm were independent risk factors for distant metastasis of primary TNBC. Moreover, higher clinical stage T and stage N were independent risk factors for bone metastasis of the patients. TNBC patients with either bone or visceral metastasis have poor survival, with brain metastasis worst of all, though the OS difference was not statistically significant. Conclusions: TNBC patients with larger age, higher clinical stage, larger tumor size were more predisposed to have distant metastasis. Great attention should be paid to the prognosis of these patients with distant metastasis.

Risk factors of distant metastasis after surgery among different breast cancer subtypes: a hospital-based study in Indonesia

“…However, specific subtypes of breast cancer in our cohort did not show a significant association with the risk of distant metastasis ( Table 5). Several studies have shown a higher risk of distant metastasis in Her-2-enriched [42] and TNBC subtype [43] and a lower risk of distant spread in the luminal subtype [42]. In this study, we showed specific risk factors of distant metastasis in luminal A-subtype, i.e., advanced stages (OR 2.160), tumor infiltration to skin and chest wall (OR 2.685), and positive axillary lymph nodes (OR 2.571).…”

Paclitaxel’s Mechanistic and Clinical Effects on Breast Cancer

“…The prevalence of TNBC as the most aggressive form is 10-20%, with higher abundance in the cohort of young women. This molecular subtype is associated with an advanced stage, higher grade of the tumor, overall worse survival rates of patients associated with cancer recurrence, and development of metastasis [24]. Immunohistochemically, TNBC is characterized by the lack of three receptors: estrogen receptor (ER), progesterone receptor (PR), and HER2.…”

Novel Medicinal Mushroom Blend as a Promising Supplement in Integrative Oncology: A Multi-Tiered Study using 4T1 Triple-Negative Mouse Breast Cancer Model

“…Nonetheless, the lack of a targeted therapy and the TNBC heterogeneity highlighted the urgent medical need to identify therapeutic targets and develop novel effective medicines capable to overcome drug resistance in this aggressive BC. A great deal of effort is currently devoted to find out whether certain treatments can interfere with cellular and molecular processes fueling TNBC growth, trying to create new medical therapies able to hinder the typical TNBC metastatic pattern (i.e., frequent occurrence of distant metastases, mainly localized in lung, central nervous system, and bones) often associated with poor prognosis [6,7].…”

“…In the present investigation, we exploited the effect of an oral supplementation with "Micotherapy U-care" (M. U-care), a novel medicinal mushroom blend, consisting of a mixture of extracts from the above reported five varieties, in a 4T1 triple-negative mouse BC model. We addressed specific endpoints and pathological outcomes of the murine pulmonary tissue, the lung being one of the distant organs frequently involved in typical metastasis pattern of primary TNBC [7]. We evaluated different markers of general lung toxicity, inflammation, fibrosis, and oxidative stress, both in parenchyma and metastases.…”