Triple Negative Breast Cancer: A Single Centre Experience

Abstract

Background: Triple-negative breast cancer (TNBC) represents a heterogeneous group of breast cancers that do not express estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 receptors. Generally, these tumors are aggressive and more common in younger women, in which an association of TNBC with mutations in the BRCA1 gene was documented. The aim of our study was to create a representative group of patients with TNBC, which could be analyzed and the data gathered to build basic epidemiological, molecular and clinical characteristics of TNBC. Methods: We retrospectively studied 516 patients diagnosed and/or treated for TNBC at our institute between 1995 and 2010. Some clinicalpathologic/ molecular correlations were performed to identify different subsets of TNBC and groups of patients who may potentially benefit from different modes of anticancer therapy. Results: The median age of patients with TNBC was 56 years (range 25-88 years). A total of 18% of TNBC cases were diagnosed in patients under the age of 34, another 44.5% and 37.5% of cases were in the age group of 35 to 44 years and up to 70 years, respectively. 'Basal-like' carcinomas accounted for 75% of TNBC. We confirmed the aggressive nature of this disease: in the median follow-up period of 7.7 years, we observed a relapse in 27.2% of patients: 71% of deaths due to disease progression occurred within 2 years after diagnosis of the disease. Treatment strategies include chemotherapy, in most cases (88.9%). Chemotherapy was mostly based on regimens with anthracyclines or in combination with taxanes. 7 year OS and DFS were 51% and 40% respectively. The most important negative prognostic factors in relation to disease specific OS were: higher clinical stage and 381 pT (bothp < 0.0001), pN-positive status (p < 0.001), absence or early withholding of chemotherapy (p < 0.001) and minimal disease response to neoadjuvant treatment (p = 0.005). Conclusion: TNBC is an aggressive form of breast cancer, which may occur in patients of all ages, but more frequently in younger patients. Early detection and intensive treatment of these tumors gives a high chance of cure. BCL2 expression analysis could facilitate decision making on adjuvant treatment in TNBC patients. Better therapeutic results can be expected from targeted therapy.