Prognostic Characteristics Of Clinicopathology In Triple-Negative Breast Cancer

Objective: To compare the clinical features,natural history,and outcomes for women with triple-negative breast cancer with women with other types of breast cancer.And analyze the prognostic factors for women with triple-negative breast cancer.Methods: We investigated a cohort of 707 patients with breast cancer, diagnosed between January 2002 and December 2004 at Fujian provincial tumor hospital. The patients were divided into five groups:group 1: the triple negative breast cancer group (ER negative,PR negative,and Her-2 negative);group 2:hormone receptor negative and Her-2 positive;group 3.hormone receptor positive and Her-2 positive;group 4.hormone receptor positive and Her-2 negative;group 5:Her-2 status unknown and regardless of the expression of hormone receptor. The clinical features, the patterns of recurrence and the status of survival were retrospectively analyzed. And the prognostic significance of triple-negative breast cancer was explored.Results: The median follow-up time of the 707 women was 49.5 months. The five subtypes accounted for 15%,11%,19%,28% and 27% respectively of these informative cases. There was no significant difference of age, menstrual status, lymph node metastasis rate , pathological stage , adjuvant chemotherapy and radiotherapy among the five groups. Compared with group 4,group 2 had positive associated with larger tumor size. The 5-year disease-free survival (DFS) rate in the all breast cancer subgroups were 61.6%,67.9%,66.8%,78.8% and 78.4% respective. And the overall survival (OS) of all breast cancer subgroups were 73.8%, 74.8%, 77.1%, 89.3% and 82.7% respective. Triple-negative breast cancer patients had positive associated with shorter 5-year disease-free survival and overall survival compared with group 4 and group 5 (P<0.05) but negative associated with 5-year DFS or OS compared with the two HER2 positive subgroups (group 2 and group 3)Patients with triple-negative breast cancer had higher rates of recurrence in visceral organs, local and soft tissue than the group 4 or group 5, but no significant difference was observed between the triple-negative breast caner and the two HER2 positive subgroups.Single factor analysis revealed, that age, the tumor size and lymph node involvement were the prognostic factors of the patients with triple-negative breast cancer. Multifactor COX regression analysis revealed that the death risk of patients with lymph node involvement was 3.497 times as much as those with lymph node negative.And death risk of the cases with age younger than 35-year-old was 3.399 times as hight as that of the cases with older than 35-year old.Conclusion:Our data suggested that, there was no significant difference of age, menstrual status, lymph node metastasis rate, pathological stage, adjuvant chemotherapy and radiotherapy among the five groups. Patients with triple-negative breast cancer had shorter DFS and OS than other subgroups of patients had. The age, tumor size and lymph node status were the independent prognostic factors in patients with triple-negative breast cancer.