Impact of triple-negative breast cancer phenotype on prognosis in patients with stage i breast cancer

Jeong Eun Kim, Heui June Ahn, Jin Hee Ahn, Dok Hyun Yoon, Sung Bae Kim, Kyung Hae Jung, Gyung Yub Gong, Mi Jung Kim, Byung Ho Son, Sei Hyun Ahn

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21 Scopus citations

Abstract

Purpose: Although most patients with stage I breast cancer have a good prognosis, their clinical outcomes may vary significantly. We assessed clinical outcomes and prognostic factors in stage I breast cancer patients with and without triple-negative breast cancer (TNBC) phenotype. Methods: Of 2,489 patients undergoing breast cancer surgery between January 1998 and December 2002, 554 (22.3%) had stage I breast cancer (tumor size ≤2 cm, and lymph node-negative). TNBC was defined as a primary tumor negative for estrogen and progesterone receptors (Allred scores <3/8) and for HER2/neu (0-1+ by immunohistochemistry). Results: Of the 554 patients with stage I breast cancer, 78 (14.1%) had TNBC. A significant proportion of TNBC patients had histologic grade 3 tumors (47.4% vs. 34.5%, p=0.031) and tumors >1 cm (87.2% vs. 75.8%, p=0.028) and received adjuvant chemotherapy (79.5% vs. 44.7%, p<0.001). During a median follow-up time of 8.7 years, 72 patients experienced tumor recurrences; 18 (23.1%) in the TNBC group and 54 (11.3%) in the non- TNBC group (p=0.010), with cumulative 3-year rate of recurrence of 12.8% and 5.3%, respectively (p=0.010). Ten-year relapse-free survival (RFS; 75.6% vs. 87.5%, p=0.004) and overall survival (OS; 83.0% vs. 91.4%, p=0.002) rates were significantly lower in the TNBC group. Multivariate analysis showed that triple negativity and histologic grade were independent predictors of shorter RFS and OS. Conclusion: TNBC had more aggressive clinicopathologic characteristics and was associated with poorer survival in patients with stage I breast cancer. More intensive adjuvant chemotherapy or a different therapeutic strategy targeting this population is warranted.

Original languageEnglish (US)
Pages (from-to)197-202
Number of pages6
JournalJournal of Breast Cancer
Volume15
Issue number2
DOIs
StatePublished - Jun 2012

Keywords

  • Breast neoplasms
  • HER2/neu
  • Prognosis

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    Kim, J. E., Ahn, H. J., Ahn, J. H., Yoon, D. H., Kim, S. B., Jung, K. H., Gong, G. Y., Kim, M. J., Son, B. H., & Ahn, S. H. (2012). Impact of triple-negative breast cancer phenotype on prognosis in patients with stage i breast cancer. Journal of Breast Cancer, 15(2), 197-202. https://doi.org/10.4048/jbc.2012.15.2.197