Time to recurrence and survival in triple negative early-stage breast cancer

Abstract

21151 Background: Breast cancer (BC) is the most common neoplasm among Mexican women. Clinical, tumoral and biologic factors have proven useful in predicting prognosis regarding recurrence and survival. Triple negative (TN) phenotype (ER, PR and HER2 negative) has been reported to be associated with more aggressive clinical behavior. Objective: To compare clinical, tumor, biologic characteristics of TN time to recurrence and survival to other phenotypes in early BC. Methods: Records of women with stage I - II BC evaluated from Jan. 2000 to June 2006 were reviewed. ER/PR+: > 10 fmol/pgr and HER2+, 3+ by immunohistochemistry or FISH > 2.2 were considered. Five groups were designed: 1) TN, 2) triple positive, 3) HER2-/ER/PR+, 4) HER2+/ER/PR-, 5) HER2-/ one hormonal receptor (HR) +. ANOVA, Chi-2 and Kruskal-Wallis tests were applied for the statistical analysis. Results: 110 patients were included (17, 14, 52, 11, 16 respectively). Median age (43, 49.5, 55, 53 51 yrs); clinical stage; tumor size, axillary lymph node status and angiogenesis score were similar in all groups, p > 0.05. Median Ki67 was higher in TN group (47.5, 20, 20, 42.5, 10, p< 0.000). Proportion of patients with conservative surgery was similar, p= 0.308. Fourteen recurrences were observed, 2 local and 12 systemic (3, 1, 3, 5, 2 in each group). Median time to recurrence (6, 54, 30, 20, 27 mos); there were 7 deaths due to tumor. Number of deaths was higher in TN and HER+/HR- (17.4, 7.1, 0, 18.1, 6.2%). Conclusions: TN phenotype represents 15% in this early BC population and was associated to higher Ki67. There are premature signs (age, number of recurrences and deaths) that suggest a poor prognosis for TN patients, similar to those with HER2+/ERPR- . No significant financial relationships to disclose.