Abstract
1057 Background: It is generally believed that triple-negative (ER-/PR-/HER2-) primary breast cancers have poor prognosis. Following surgery, adjuvant chemotherapy is currently the only treatment that could potentially improve survival. On the other hand, the absolute benefit of adjuvant chemotherapy in older women appears small and its precise value remains to be proven. As such its use tends to be very limited in this population. Methods: Over 36 years (1973−2009), 2,000+ older (≥70 years) women with early operable primary breast cancer were managed in a dedicated clinic. Of these 127 patients with triple negative invasive carcinoma (defined as ER/PR = 0% positive cells, HER2 = 1+ or 2+ on IHC and CISH negative) underwent primary surgery and had good quality tumour samples available for tissue microarray (TMA) analysis using indirect immunohistochemistry. The results were compared with their younger (<70 years) counterparts from a previously characterised, consecutive series (N=1,809) treated in the same unit (1986–1998). Among them, there were 342 patients who had triple negative tumors. Results: At a median follow-up of 46 months (longest=204) (≥70 years) and 119 months (longest=135) (<70 years), the results are shown in the table. Conclusions: Despite not having received adjuvant chemotherapy, the older series had clinical outcome similar to the younger patients almost half of which had chemotherapy. This may be due to other biomarkers (in addition to ER/PR/HER2) which have different patterns in these age groups influencing prognosis. The place of adjuvant chemotherapy in the treatment of these patients has yet to be identified. Treatment pattern <70 years ≥70 years With adjuvant chemotherapy 149 (47.0%) 0 Without adjuvant chemotherapy 168 (53.0%) 127 (100%) Outcome at 5 years P value Breast cancer-specific survival 73% 79% 0.39 Local recurrence 10% 14% 0.16 Regional recurrence 11% 14% 0.40 Metastases 30% 27% 0.56
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