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Clinical characteristics, risk factors, and outcomes in Chilean triple negative breast cancer patients: a real-world study

  • Epidemiology
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Abstract

Background

Latin American (LA) studies on triple-negative breast cancer (TNBC) and their characteristics are scarce. This forces physicians to make clinical decisions based on data obtained from studies that include non-Hispanic patients. Our study sought to obtain local epidemiological data, including risk factors and clinical outcomes from a Chilean BC registry.

Methods

This was a retrospective population-cohort study that included patients treated at a community hospital (mid-low income) or an academic private center (high income), in the 2010–2021 period. Univariate and multivariate analyses were performed to identify prognostic factors associated with survival.

Results

647 out of 5,806 BC patients (11.1%) were TNBC. These patients were younger (p = 0.0001) and displayed lower rates of screening-detected cases (p = 0.0001) compared to non-TNBC counterparts. Among TNBC patients, lower income (i. e., receiving treatment at a community hospital) was associated with poorer overall survival (HR: 1.53; p = 0.0001) and poorer BC specific survival (HR: 1.29; p = 0.004). Other risk factors showed no significant differences between TNBC and non-TNBC. As expected, 5-year OS was significantly shorter on TNBC versus non-TNBC patients (p = 0.00001). In our multivariate analyses TNBC subtype (HR: 2.30), locally advanced stage (HR: 7.04 for stage III), lower income (HR: 1.64), or non-screening detected BC (HR: 1.32) were associated with poorer OS.

Conclusion

To the best of our knowledge, this is the largest LA cohort of TNBC patients. Interestingly, the proportion of TNBC among Chileans was smaller compared to similar studies within LA. As expected, TNBC patients had poorer survival and higher risk for early recurrence versus non-TNBC. Other relevant findings include a higher proportion of premenopausal patients among TNBC. Also, mid/low-income patients that received medical attention at a community hospital displayed lower survival versus private health center counterparts.

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Data availability

The analyses during the current study can be available from the corresponding author on reasonable request.

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Acknowledgements

Fundación Chile sin cáncer

Funding

This work was supported by FONDECYT-Initiation grant #11161103 (CS) and Pfizer cyber grant #60322449.

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Authors and Affiliations

  1. Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile

    Francisco Acevedo, Benjamín Walbaum, Tomas Merino, Catherine Bauerle & César Sánchez

  2. Centro de Cáncer, Red de Salud UC Christus, Pontificia Universidad Católica de Chile, Santiago, Chile

    Lidia Medina

  3. Departamento de Cirugía Oncológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

    Mauricio Camus & Francisco Dominguez

  4. Departmento de Medicina Familiar, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

    Klaus Puschel

  5. Departamento Ciencias de la Salud, Facultad de Medicina, Carrera de Kinesiología, Pontificia Universidad Católica de Chile, Santiago, Chile

    Karol Ramírez

  6. Hospital Dr. Sotero del Rio, Puente Alto, Santiago, Chile

    Manuel Manzor, Paulina Veglia, Raúl Martinez, Constanza Guerra & Marisel Navarro

Authors
  1. Francisco Acevedo
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  15. César Sánchez
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by FA, BW, LM, and CS. The first draft of the manuscript was written by FA and CS. All authors read and approved the final manuscript.

Corresponding author

Correspondence to César Sánchez.

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Conflict of interests

Authors are required to disclose financial or non-financial interests that are directly or indirectly related to the work submitted for publication.

Ethics approval

Our procedures respected ethical standards in accordance with the Declaration of Helsinki (updated in 2013) and were reviewed and approved by a Human Research Ethics Committee at our institution (School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; approval resolution number: 200303006).

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Acevedo, F., Walbaum, B., Medina, L. et al. Clinical characteristics, risk factors, and outcomes in Chilean triple negative breast cancer patients: a real-world study. Breast Cancer Res Treat 197, 449–459 (2023). https://doi.org/10.1007/s10549-022-06814-x

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