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The clinicopathologic characteristics and prognostic significance of triple-negativity in node-negative breast cancer.

Rhee J, Han SW, Oh DY, Kim JH, Im SA, Han W, Park IA, Noh DY, Bang YJ, Kim TY - BMC Cancer (2008)

Bottom Line: Clinicopathologic variables and clinical outcomes were evaluated.It also correlated with a molecular profile associated with biological aggressiveness: negative for bcl-2 expression (p < 0.001), positive for the epidermal growth factor receptor (p = 0.003), and a high level of p53 (p < 0.001) and Ki67 expression (p < 0.00).On multivariate analysis, young age, close resection margin, and triple-negativity were independent predictors of shorter RFS.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. splendor97@gmail.com

ABSTRACT

Background: Triple-negative (TN) breast cancer, which is defined as being negative for the estrogen receptor (ER), the progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER-2), represents a subset of breast cancer with different biologic behaviour. We investigated the clinicopathologic characteristics and prognostic indicators of lymph node-negative TN breast cancer.

Methods: Medical records were reviewed from patients with node-negative breast cancer who underwent curative surgery at Seoul National University Hospital between Jan. 2000 and Jun. 2003. Clinicopathologic variables and clinical outcomes were evaluated.

Results: Among 683 patients included, 136 had TN breast cancer and 529 had non-TN breast cancer. TN breast cancer correlated with younger age (< 35 y, p = 0.003), and higher histologic and nuclear grade (p < 0.001). It also correlated with a molecular profile associated with biological aggressiveness: negative for bcl-2 expression (p < 0.001), positive for the epidermal growth factor receptor (p = 0.003), and a high level of p53 (p < 0.001) and Ki67 expression (p < 0.00). The relapse rates during the follow-up period (median, 56.8 months) were 14.7% for TN breast cancer and 6.6% for non-TN breast cancer (p = 0.004). Relapse free survival (RFS) was significantly shorter among patients with TN breast cancer compared with those with non-TN breast cancer (4-year RFS rate 85.5% vs. 94.2%, respectively; p = 0.001). On multivariate analysis, young age, close resection margin, and triple-negativity were independent predictors of shorter RFS.

Conclusion: TN breast cancer had higher relapse rate and more aggressive clinicopathologic characteristics than non-TN in node-negative breast cancer. Thus, TN breast cancer should be integrated into the risk factor analysis for node-negative breast cancer.

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Kaplan-Meier plot of RFS according to triple negative (TN) phenotype.
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Figure 1: Kaplan-Meier plot of RFS according to triple negative (TN) phenotype.

Mentions: The 4-year RFS rates in patients with TN breast cancer and non-TN breast cancer were 85.5% and 94.2%, respectively (p = 0.001) (Figure 1). Eighteen patients (90.0%) with relapsed TN breast cancer had their relapses within 3 years after surgery, whereas 19 patients (57.3%) with relapsed non-TN breast cancer had relapses within 3 year after surgery (p = 0.007) (Figure 2). The distribution of the sites of recurrence (distant, locoregional, or contralateral breast) was not statistically different between TN and non-TN breast cancer (p = 0.968). TN breast cancer patients who were younger had shorter RFS than those without these features (p = 0.028). Patients with TN disease also had shorter RFS than patients who were HR-positive (p < 0.001) or HR-negative/HER2 -positive (p = 0.384) (Figure 3).


The clinicopathologic characteristics and prognostic significance of triple-negativity in node-negative breast cancer.

Rhee J, Han SW, Oh DY, Kim JH, Im SA, Han W, Park IA, Noh DY, Bang YJ, Kim TY - BMC Cancer (2008)

Kaplan-Meier plot of RFS according to triple negative (TN) phenotype.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2577689&req=5

Figure 1: Kaplan-Meier plot of RFS according to triple negative (TN) phenotype.
Mentions: The 4-year RFS rates in patients with TN breast cancer and non-TN breast cancer were 85.5% and 94.2%, respectively (p = 0.001) (Figure 1). Eighteen patients (90.0%) with relapsed TN breast cancer had their relapses within 3 years after surgery, whereas 19 patients (57.3%) with relapsed non-TN breast cancer had relapses within 3 year after surgery (p = 0.007) (Figure 2). The distribution of the sites of recurrence (distant, locoregional, or contralateral breast) was not statistically different between TN and non-TN breast cancer (p = 0.968). TN breast cancer patients who were younger had shorter RFS than those without these features (p = 0.028). Patients with TN disease also had shorter RFS than patients who were HR-positive (p < 0.001) or HR-negative/HER2 -positive (p = 0.384) (Figure 3).

Bottom Line: Clinicopathologic variables and clinical outcomes were evaluated.It also correlated with a molecular profile associated with biological aggressiveness: negative for bcl-2 expression (p < 0.001), positive for the epidermal growth factor receptor (p = 0.003), and a high level of p53 (p < 0.001) and Ki67 expression (p < 0.00).On multivariate analysis, young age, close resection margin, and triple-negativity were independent predictors of shorter RFS.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. splendor97@gmail.com

ABSTRACT

Background: Triple-negative (TN) breast cancer, which is defined as being negative for the estrogen receptor (ER), the progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER-2), represents a subset of breast cancer with different biologic behaviour. We investigated the clinicopathologic characteristics and prognostic indicators of lymph node-negative TN breast cancer.

Methods: Medical records were reviewed from patients with node-negative breast cancer who underwent curative surgery at Seoul National University Hospital between Jan. 2000 and Jun. 2003. Clinicopathologic variables and clinical outcomes were evaluated.

Results: Among 683 patients included, 136 had TN breast cancer and 529 had non-TN breast cancer. TN breast cancer correlated with younger age (< 35 y, p = 0.003), and higher histologic and nuclear grade (p < 0.001). It also correlated with a molecular profile associated with biological aggressiveness: negative for bcl-2 expression (p < 0.001), positive for the epidermal growth factor receptor (p = 0.003), and a high level of p53 (p < 0.001) and Ki67 expression (p < 0.00). The relapse rates during the follow-up period (median, 56.8 months) were 14.7% for TN breast cancer and 6.6% for non-TN breast cancer (p = 0.004). Relapse free survival (RFS) was significantly shorter among patients with TN breast cancer compared with those with non-TN breast cancer (4-year RFS rate 85.5% vs. 94.2%, respectively; p = 0.001). On multivariate analysis, young age, close resection margin, and triple-negativity were independent predictors of shorter RFS.

Conclusion: TN breast cancer had higher relapse rate and more aggressive clinicopathologic characteristics than non-TN in node-negative breast cancer. Thus, TN breast cancer should be integrated into the risk factor analysis for node-negative breast cancer.

Show MeSH
Related in: MedlinePlus