The influence of triple-negative status on survival of patients with early-stage breast cancer treated in a Brazilian outpatient cancer center.

Abstract

e11539 Background: Triple-negative (TN) breast cancer is an aggressive disease with intrinsic poor prognosis. This breast cancer subtype is defined as negative expression for estrogen/progesterone receptors and HER2, and it is managed with standard chemotherapy - including anthracycline and taxanes. The objective of this study was to evaluate, in a real world perspective, the impact of TN status on survival among early-stage breast cancer patients treated in a private oncologic center in Brazil. Methods: We retrospectively studied 721 patients with early-stage breast cancer between 1999 and 2009. Clinical characteristics and outcomes were described and compared for TN and non-TN patients. Variables were compared using Mann-Whitney test, and survival curves were estimated with Kaplan-Meier method, and compared with log-rank (SPSS v 17.0 software). Results: 102 (14%) patients were classified as TN and showed less differentiated and more advanced tumors. The rate of grade 3 tumors was 55% and 22% for TN and non-TN groups (P<.0001), while the rate of stage II-III was 65% and 55% (P=.07). Accordingly, the survival was considerably worst among TN patients, with 5-year overall survival of 79% vs 92% (P<.001). Of note, no difference was detected regarding median age (54 vs 53 years; P=.99), median tumor size (2 cm for both; P=.25), and nodal positivity (64% vs 62%; P=.75) for TN and non-TN, respectively. The rate of adjuvant/neoadjuvant treatment was 98% for TN and 100% for non-TN patients, and taxanes were used in 55% in both situations. Conclusions: Our findings are consistent with current worldwide literature, and confirm that TN status is associated with shorter survival among early-stage breast cancer patients in a Brazilian cancer registry. Moreover, our group identified significantly worst tumor features among TN patients, including undifferentiated and advanced tumors.