Triple negative breast cancer in Iranian women: Clinical profile and survival study

Abstract

Background: Triple negative breast cancer (TNBC) is characterized by negative result of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in immunohistochemical (IHC) staining and an interesting topic of research today. Various studies have been reported in western countriesonTNBC, all insisted of the poorer prognostic of TNBCthan other subtypes of breast cancer. However extensive data from Iran is lacking. Objectives: The aim of this study was to analyze the clinical, pathological profile and survival of TNBC patients at our institute. Methods: Medical records of 1910 breast cancer patients in the Shahid Beheshti University of Medical Sciences cancer research center database with data on 180 patients of TNBC patients was collected between September 2002 and December 2014 and reviewed for clinicopathological profile and survival analysis. Results: The median age at diagnosis was 48 years. Fourteen patients (7.8 %) had stage I, 88 patients (48.9%) had stage II, 57 (31.7 %) had stage III, 8 (4.4%) patients had stage IV at first diagnosis and 13 patients (7.2%) with unknown stage. The median follow-up time was 41 months. 149 patients were without any with recurrences at the last follow up and 31 patients were with recurrence. Median interval for recurrence development was 39 months. Five years disease free survival (DFS) was 71%. Overall survival (OS) at 5 years for all patients was 56%. According to univariate cox regression 5-year DFS analysis, unfavorable prognostic factors in our study were as follows: grade III of tumor, positive LVI, presence of lymph node positive, stage II and stage III at diagnosis. According to multivariate cox regression 5-year OS analysis unfavorable prognostic factors were as follows: age: 40, grade III versus grade I of tumor, stage III at diagnosis versus Stage I, and visceral recurrence. Conclusions: We observed that most clinical and pathological TNBC characteristics in Iranian patients are consistent with others findings in literature, such as younger age at diagnosis, high grade tumors, advanced stage at diagnosis, and short time of 5-year DFS and 5-year OS. Longer follow-up of these patients is required for more mature data on these cancers.