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A Comparative Study of Clinical Profile and Relapse Patterns in TRIPLE-NEGATIVE and Non-Triple-Negative Breast Cancer Patients Treated with Curative Intent

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Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Molecular subtyping in breast cancer is recently emerging as an important determinant of treatment and outcomes, and triple negative breast cancer (TNBC) has been established as a distinct clinical entity with unique features and adverse outcomes. A retrospective analysis of a prospectively maintained computerized breast cancer database was performed, and all the non-metastatic female breast cancer patients undergoing potentially curative multimodality treatment between 2005 and 2012 were included for analysis. Patients with incomplete information regarding ER, PR, and HER2/neu status were excluded. All the eligible patients were divided into TNBC and non-TNBC group based on molecular subtyping. A comparative analysis between the two groups was performed to analyze the clinical spectrum and patterns of relapse. A total of 861 patients qualified for the final analysis and the proportion of TNBC was 254 (29.5%) and non-TNBC was 607 (70.5%). Patients in the TNBC group were slightly younger than the non-TNBC group (median age 46 vs. 49, p value = 0.006). TNBC group had a higher breast conservation surgery (BCS) rate, and there was no difference in the need for chemo and radiotherapy between two groups. The overall recurrence rates were significantly higher in TNBC group compared to non-TNBC group (26.8 vs. 19.3%, p value = 0.01). Local disease recurrences were significantly higher in TNBC compared to non-TNBC (7.9 vs. 3.1%, p value = 0.002). Both the regional and systemic recurrences were higher in TNBC group compared to non-TNBC, though the difference failed to attain statistical significance (for regional recurrences 2.4 vs. 1.5%, p value = 0.36; for systemic recurrences 23.2 vs. 17.8%, p value = 0.06). The brain metastasis was significantly higher in TNBC group (6.7 vs. 3.3%, p value = 0.02). In addition, time to relapse was also significantly less in TNBC cohort (16.1 vs. 22.1 months). TNBC accounts for almost one-third of the breast cancer patients with a relatively younger age at presentation, higher volume of disease burden and high breast conservation rates. Despite a standard multimodality therapy the local, systemic, and CNS recurrence rates are high in TNBC and majority relapse within first 2 years after completion of therapy.

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References

  1. Deo SVS (2010) Challenges in the treatment of breast cancer in developing countries. Natl Med J India 23:129–131

    PubMed  Google Scholar 

  2. Garg PK, Deo SVS, Kumar R (2015) Role of positron emission tomography-computed tomography in locally advanced breast cancer. Indian J Surg Oncol 6:420–426

    Article  PubMed  PubMed Central  Google Scholar 

  3. Garg PK, Deo SVS, Kumar R, Shukla NK, Thulkar S, Gogia A, Sharma DN, Mathur SR (2016) Staging PET-CT scanning provides superior detection of lymph nodes and distant metastases than traditional imaging in locally advanced breast cancer. World J Surg 40(8):2036–2042

    Article  PubMed  Google Scholar 

  4. Perou CM, Sørlie T, Eisen MB et al (2000) Molecular portraits of human breast tumours. Nature 406:747–752

    Article  CAS  PubMed  Google Scholar 

  5. Sorlie T, Perou CM, Tibshirani R, Aas T et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 11 98(19):10869–10874

    Article  CAS  Google Scholar 

  6. Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V (2007) Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California cancer Registry. Cancer 109:1721–1728

    Article  PubMed  Google Scholar 

  7. Boyle P (2012) Triple-negative breast cancer: epidemiological considerations and recommendations. Ann Oncol 23:vi7–v12

    Article  PubMed  Google Scholar 

  8. Qiu J, Xue X, Hu C et al (2016) Comparison of clinicopathological features and prognosis in triple-negative and non-triple negative breast cancer. J Cancer 7:167–173

    Article  PubMed  PubMed Central  Google Scholar 

  9. Gogia A, Raina V, Deo SVS, Shukla NK, Mohanti BK (2014) Triple-negative breast cancer: An institutional analysis. Indian J Cancer 51:163–166

    Article  CAS  PubMed  Google Scholar 

  10. Gupta S (2013) Triple negative breast cancer: A continuing challenge. Indian J Med Paediatr Oncol 34:1–2

    Article  PubMed  PubMed Central  Google Scholar 

  11. Nabi MG, Ahangar A, Wahid MA, Kuchay S (2015) Clinicopathological comparison of triple negative breast cancers with non-triple negative breast cancers in a hospital in North India. Niger J Clin Pract 18:381–386

    Article  CAS  PubMed  Google Scholar 

  12. Deo SVS, Bhutani M, Shukla NK, Raina V, Rath GK, Purkayasth J (2003) Randomized trial comparing neo-adjuvant versus adjuvant chemotherapy in operable locally advanced breast cancer (T4b N0-2 M0). J Surg Oncol 84(4):192–197

    Article  CAS  PubMed  Google Scholar 

  13. Garg PK, Mohanty D (2013) Mean (standard deviation) or mean (standard error of mean): time to ponder. World J Surg 37:932

    Article  PubMed  Google Scholar 

  14. Choudhary D, Garg PK (2013) 95% confidence interval: a misunderstood statistical tool. Indian J Surg 75:410

    Article  PubMed  Google Scholar 

  15. Garg PK (2015) Large standard deviation: think before you write. World J Surg 39:808–809

    Article  PubMed  Google Scholar 

  16. Sharma B, Satyanarayan KA, Sharma N, Kapoor A, Kumar N (2013) Five year retrospective survival analysis of triple negative breast cancer in North-West India. Indian J Cancer 50:330–332

    Article  CAS  PubMed  Google Scholar 

  17. Sharma M, Sharma JD, Sarma A et al (2014) Triple negative breast cancer in people of North East India: critical insights gained at a regional cancer centre. Asian Pac J Cancer Prev 15:4507–4511

    Article  PubMed  Google Scholar 

  18. Clarke CA, Keegan THM, Yang J et al (2012) Age-specific incidence of breast cancer subtypes: understanding the black–white crossover. J Natl Cancer Inst 104:1094–1101

    Article  PubMed  PubMed Central  Google Scholar 

  19. Dogra A, Doval DC, Sardana M, Chedi SK, Mehta A (2014) Clinicopathological characteristics of triple negative breast cancer at a tertiary care hospital in India. Asian Pac J Cancer Prev 15:10577–10583

    Article  PubMed  Google Scholar 

  20. Cancello G, Maisonneuve P, Rotmensz N et al (2010) Prognosis and adjuvant treatment effects in selected breast cancer subtypes of very young women (<35 years) with operable breast cancer. Ann Oncol 21:1974–1981

    Article  CAS  PubMed  Google Scholar 

  21. Liedtke C, Mazouni C, Hess KR et al Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. J Clin Oncol 26:1275–1281

  22. Kim E-K, Noh WC, Han W, Noh D-Y (2011) Prognostic significance of young age (<35 years) by subtype based on ER, PR, and HER2 status in breast cancer: a nationwide registry-based study. World J Surg 35:1244–1253

    Article  PubMed  Google Scholar 

  23. Lowery AJ, Kell MR, Glynn RW, Kerin MJ, Sweeney KJ (2012) Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat 133:831–841

    Article  PubMed  Google Scholar 

  24. Ribelles N, Perez-Villa L, Jerez JM et al (2013) Pattern of recurrence of early breast cancer is different according to intrinsic subtype and proliferation index. Breast Cancer Res 15(5):R98

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lin NU, Claus E, Sohl J, Razzak AR, Arnaout A, Winer EP (2008) Sites of distant relapse and clinical outcomes in patients with metastatic triple-negative breast cancer: high incidence of central nervous system metastases. Cancer 113:2638–2645

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Surgical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India

    Suryanarayana V. S. Deo, Nootan Kumar Shukla, Ashish Jakhetiya, Dillip Kumar Muduly & Pankaj Kumar Garg

  2. Department of Medical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India

    Ajay Gogia

  3. Department of Radiation Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India

    Daya Nand Sharma

  4. Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, 110095, India

    Pankaj Kumar Garg

  5. Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India

    Sandeep R Mathur

  6. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India

    V. S. Reenivas

Authors
  1. Suryanarayana V. S. Deo
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  2. Nootan Kumar Shukla
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  3. Ajay Gogia
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  4. Daya Nand Sharma
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  5. Ashish Jakhetiya
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  6. Dillip Kumar Muduly
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  7. Pankaj Kumar Garg
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  8. Sandeep R Mathur
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  9. V. S. Reenivas
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Correspondence to Suryanarayana V. S. Deo.

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Retrospective Study

For this kind of study, formal consent is not required. Complete anonymity is maintained for all included participants.

This article does not contain any studies with animals performed by any of the authors.

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Deo, S.V.S., Shukla, N.K., Gogia, A. et al. A Comparative Study of Clinical Profile and Relapse Patterns in TRIPLE-NEGATIVE and Non-Triple-Negative Breast Cancer Patients Treated with Curative Intent. Indian J Surg Oncol 8, 291–297 (2017). https://doi.org/10.1007/s13193-017-0634-5

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  • DOI: https://doi.org/10.1007/s13193-017-0634-5

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