Analysis of the radio-pathological factors of triple negative breast cancer and determination of risk profiles

Abstract

ObjectiveTriple-negative tumours are the most aggressive type of breast cancer. We aimed to analyse the main radiologic and histopathologic factors of these tumours to create a risk profile. Materials and methodsWe analysed data from 140 patients diagnosed with triple-negative breast cancer between January 2007 and December 2016, with follow-up through April 2018. We analysed the following variables in the breast MRI done for staging: size, necrosis, associated findings, adenopathies, and perfusion and diffusion parameters. We analysed the following variables in histopathologic studies of biopsy specimens: histological type, Scarf-Bloom, Ki67, and p53 in the infiltrating component as well as in the in situ component. We analysed the following variables in histopathologic studies of positive lymph nodes and surgical specimens: size, lymphovascular/perineural invasion, and microglandular adenosis. We analysed the relation between the radiologic and histopathologic factors and recurrence and disease-free survival. ResultsMRI tumour size ≥25mm, non-nodular enhancement, breast oedema, areola-nipple complex retraction, and lymph-node involvement were associated with recurrence and lower disease-free survival. Invasive lobular carcinoma, postsurgical size ≥20mm, and p53<15% were also associated with recurrence and lower disease-free survival. Histologically positive lymph nodes were associated with a greater percentage of recurrence and lymphovascular invasion and with lower disease-free survival. The multivariate analysis found that the variables MRI size ≥25mm, non-nodular enhancement, adenopathies on MRI, and p53 expression <15% were independent predictors of lower disease-free survival. ConclusionsIn triple-negative breast tumours, factors associated with lower disease-free survival are non-nodular enhancement, size ≥25mm, and adenopathies on MRI, and p53 expression <15% on histopathologic study.