Abstract
ABSTRACT Background Triple negative breast cancer (TNBC) patients (pts) is an heterogeneous population regarding prognostic. Therefore, clinical and histological features were evaluated in a large monocenter cohort of patients treated for localized TNBC to identify good-prognostic TNBC. Methods All consecutive early-stage TNBC (ER 0%, PR 0%, HER2 neg) patients treated at European Georges Pompidou Hospital, Paris, France, between 2000 and 2011 were included. Records were reviewed for demographic, clinical and pathological data. Prognostic factors were determined using univariate and multivariate stepwise log-rank analysis on disease-free survival (DFS) and overall survival (OS). Results This analysis included 128 women with early-stage TNBC. Clinical and histological characteristics are summarized below. After a median follow-up of 37 months 36 relapses and 19 deaths were observed. The 3-years recurrence rate was 30% (95%CI 22-40) in the whole population. For DFS, bad prognostic factors in univariate analysis were: large tumor size (T3-4), node involvement (N1-3), node capsular effraction, lymphovascular invasion (LVI) and high grade (SBR 2-3). Multivariate analysis identified tumor size (T3-4) (HR 3.70, 95%CI 1.61-8.52) and LVI (HR 2.87, 95%CI 1.39-5.93) as independent factors. The 3-years recurrence rate remained high (20%, 95%CI 10-34) in patients with two good prognostic factors (T0-2 and no LVI). For OS, bad prognostic factors significant in univariate and multivariate analysis were: node capsular effraction (HR 3.57, 95%CI 1.17-10.92) and LVI (HR 3.43, 95%CI 1.18-9.92). Conclusions In this early-stage TNBC series, LVI was a bad prognostic factor of relapse and death. However, the 3-years recurrence rate remained high in patients with good prognostic features. Therefore, new biomarkers are mandatory for a better stratification of this heterogeneous population. Clinical and histological characteristics N (128pts) % Median age (yrs) 56 range 22-88 Histological type Invasive ductal carcinoma 123 96 Invasive lobular carcinoma 5 4 Tumor stage T0-T2 105 82 T3-T4 23 18 Node stage N0 97 76 N1-3 31 24 Node capsular effraction pos 14 11 neg 111 87 NE 3 2 Tumor grade (SBR) 1 8 6 2-3 107 84 NE * 13 10 Lymphovascular invasion (LVI) pos 34 27 neg 74 58 NE ** 20 16 * Due to neoaduvant chemotherapy ** Due to small biopsies. Disclosure S. Haouas: Grant from Association pour la Recherche en Therapeutiques Innovantes en Cancerologie (ARTIC). All other authors have declared no conflicts of interest.
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