Breast Cancer Research and Treatment

, Volume 161, Issue 2, pp 279–287 | Cite as

Triple-negative breast cancer has worse overall survival and cause-specific survival than non-triple-negative breast cancer

  • Xiaoxian LiEmail author
  • Jing Yang
  • Limin Peng
  • Aysegul A. Sahin
  • Lei Huo
  • Kevin C. Ward
  • Ruth O’Regan
  • Mylin A. Torres
  • Jane L. Meisel
Preclinical study



The current American Joint Committee on Cancer (AJCC) staging manual uses tumor size, lymph node, and metastatic status to stage breast cancer across different subtypes. We examined the prognosis of triple-negative breast cancer (TNBC) versus non-TNBC within the same stages and sub-stages to evaluate whether TNBC had worse prognosis than non-TNBC.


We reviewed the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) data and identified 158,358 patients diagnosed with breast cancer from 2010 to 2012. The overall survival (OS) time and breast cancer cause-specific survival time were compared between patients with TNBC and non-TNBC in each stage and sub-stages. The results were validated using a dataset of 2049 patients with longer follow-up from our institution.


Compared with patients with non-TNBC, patients with TNBC had worse OS and breast cancer cause-specific survival time in every stage and sub-stage in univariate and multivariate analyses adjusting for age, race, tumor grade, and surgery and radiation treatments in the SEER data. The worse OS time in patients with TNBC was validated in our institutional dataset.


Patients with TNBC have worse survival than patients with non-TNBC. The new AJCC staging manual should consider breast cancer biomarker information.


Triple-negative breast cancer TNBC Prognosis Overall survival Cause-specific survival AJCC Cancer staging 


Authors Contributions

Conception and design: XL, LP, LH, JLM. Analysis and interpretation of data: All authors. Manuscript drafting and reviewing: All authors. XL is responsible for the overall content.

Compliance with ethical standards

Conflict of interest

All authors declare no conflict of interest.

Human and animal rights

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

Supplementary material

10549_2016_4059_MOESM1_ESM.pdf (20 kb)
Supplementary Figure Kaplan-Meier survival curves of all four subtype breast cancers in different stages from the National Cancer Institute Surveillance, Epidemiology and End Result (SEER) data. Triple negative breast cancer had worse overall survival times than other subtypes in all sub-stages except for in stage IA and IB when compared with the hormonal receptor posive/HER2- breast cancer. Hazard ratio and P values are summerized in table 5 (PDF 20 kb)
10549_2016_4059_MOESM2_ESM.docx (20 kb)
Supplementary Tables (DOCX 18 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory Medicine, Glenn Family Breast Center, Winship Cancer InstituteEmory UniversityAtlantaUSA
  2. 2.Department of Biostatistics and BioinformaticsEmory UniversityAtlantaUSA
  3. 3.Department of PathologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  4. 4.Department of MedicineUniversity of WisconsinMadisonUSA
  5. 5.Department of Radiation Oncology, Glenn Family Breast Center, Winship Cancer InstituteEmory UniversityAtlantaUSA
  6. 6.Department of Hematology and Medical Oncology, Glenn Family Breast Center, Winship Cancer InstituteEmory UniversityAtlantaUSA

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