Annals of Surgical Oncology

, 18:3164 | Cite as

Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation

  • Farrell C. Adkins
  • Ana Maria Gonzalez-Angulo
  • Xiudong Lei
  • Leonel F. Hernandez-Aya
  • Elizabeth A. Mittendorf
  • Jennifer K. Litton
  • Jamie Wagner
  • Kelly K. Hunt
  • Wendy A. Woodward
  • Funda Meric-BernstamEmail author
American Society of Breast Surgeons



Triple-negative breast cancer (TNBC) is an aggressive subtype shown to have a high risk of locoregional recurrence (LRR). The purpose of this study was to determine the impact of operation type on LRR in TNBC patients.


A total of 1325 patients with TNBC who underwent breast-conserving therapy (BCT) or mastectomy from 1980 to the present were identified. Clinical and pathological factors were compared by the chi-square test. LRR-free survival (LRRFS), distant metastasis-free survival, and overall survival were estimated by the Kaplan–Meier method. Multivariate analysis was performed by the Cox proportional hazard models.


BCT was performed in 651 patients (49%) and mastectomy in 674 (51%). The mastectomy group had larger tumors, a higher incidence of lymphovascular invasion, and higher pathologic N stage (all P < 0.001). At 62-month median follow-up, LRR was seen in 170 (26%) in the BCT group and 203 (30%) in the mastectomy group. Five-year LRRFS rates were higher in the BCT group (76% vs. 71%, P = 0.032), as was distant metastasis-free survival (68% vs. 54%, P < 0.0001) and overall survival (74% vs. 63%, P < 0.0001). On multivariate analysis, T stage (hazard ratio [HR] 1.37, P = 0.006), high nuclear grade (HR 1.92, P = 0.002), lymphovascular invasion (HR 1.93, P < 0.0001), close/positive margins (HR 1.89, P < 0.0001), and use of non–anthracycline or taxane-based adjuvant chemotherapy (HR 2.01, P < 0.0001) increased the LRR risk, while age >50 years was protective (HR 0.73, P = 0.007). Operation type (mastectomy vs. BCT, HR 1.07, P = 0.55) was not statistically significant.


BCT is not associated with increased LRR rates compared to mastectomy. TNBC should not be considered a contraindication for breast conservation.


Overall Survival Mastectomy Group Contralateral Prophylactic Mastectomy Ipsilateral Breast Tumor Recurrence TNBC Patient 
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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Farrell C. Adkins
    • 1
  • Ana Maria Gonzalez-Angulo
    • 2
  • Xiudong Lei
    • 3
  • Leonel F. Hernandez-Aya
    • 2
  • Elizabeth A. Mittendorf
    • 1
  • Jennifer K. Litton
    • 2
  • Jamie Wagner
    • 1
  • Kelly K. Hunt
    • 1
  • Wendy A. Woodward
    • 4
  • Funda Meric-Bernstam
    • 1
    Email author
  1. 1.Department of Surgical OncologyThe University of Texas, M. D. Anderson Cancer CenterHoustonUSA
  2. 2.Department Breast Medical OncologyThe University of Texas, M. D. Anderson Cancer CenterHoustonUSA
  3. 3.Department of BiostatisticsThe University of Texas, M. D. Anderson Cancer CenterHoustonUSA
  4. 4.Department of Radiation OncologyThe University of Texas, M. D. Anderson Cancer CenterHoustonUSA

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