Analysis of pattern, time and risk factors influencing recurrence in triple-negative breast cancer patients

Abstract

The aim of the study was to assess the rate, pattern, and time of recurrence in patients with triple-negative breast cancer (TNBC) and to evaluate factors influencing recurrence and overall survival in this group of patients. Out of 2,534 consecutive breast cancer patients diagnosed between January 2005 and December 2006, 228 (9 %) were TNBC (ER/PR/HER2-negative). The clinicopathological characteristics were determined using descriptive statistics. The overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan–Meier method. The univariate and multivariate analyses were developed to identify factors influencing recurrence and survival in TNBC patients. After 6 years of observation, metastatic disease occurred in 35 % of all TNBC patients: 15 % in the brain, 14 % in the lungs, 11 % in the bones, 8 % in the liver, and 14 % had locoregional relapse. The highest risk of recurrence was during the first 3 years after primary treatment, and then, during the next 2 years of observation, it did not change. 6-year DFS and OS were 68 and 62 %, respectively. Factors influencing recurrence were tumor size and systemic adjuvant chemotherapy, while factors influencing overall survival were tumor size, nodal status, adjuvant/neoadjuvant treatment, and metastases in the brain, liver, and bones. Characteristic pattern of recurrence in time was revealed. The tumor size was responsible for recurrence despite lack of involvement of lymph nodes. Aggressive adjuvant/neoadjuvant treatment ordered in all clinical stages of TNBC (including N0) was factor responsible for avoiding local and distant relapse and prolonging overall survival.

Breast Cancer in Women: Recurrence and Survival at Five Years

“…24 The period of highest risk of recurrence within the first three years after the primary treatment was identified by other researchers who also reported that the brain and lungs (15.0% and 14.0%, respectively) are the most common sites for metastasis. 22 In contrast, we verified in this study that bones and the lungs (35.5% and 25.3%, respectively) were the most common sites for recurrence.…”

“…25 According to a study conducted with patients cared for by a Cancer Center and Oncology Institute in Warsaw, Poland, survival rates were different depending on the site of metastasis; shorter length of survival was observed in cases of liver metastasis (3.5 months) and higher survival for lung metastasis (9.8 months) and local recurrence (9 months). 22 In this study, the highest occurrence of metastasis (25.2%) in a five-year period was verified between 2008 and 2013 in Goiania-GO, compared with 10.20% for distance metastasis in the same city in the period from 1989 to 2003. 26 This increase may be explained by technological advancements that facilitated the identification of breast cancer recurrence over the years.…”

“…After follow-up of 2,534 women with breast cancer in Poland for six years, 35.0% experienced metastasis, 14.0% loco-regional recurrence and 39.0% died. 22 This difference is due the fact that these women presented triple negative breast cancer, which has a worse diagnosis when compared to non-triple negative breast cancer, with high recurrence rates. 23 The metastasis and recurrence rates found in this study were not categorized according to hormonal receptors.…”

Padrão de metástase no câncer de mama triplo negativo

“…Os carcinomas de mama TN têm um padrão característico de recorrência e metástase tumoral. Em estudo realizado com 228 pacientes diagnosticadas com câncer de mama TN, um terço apresentou doença metastática 19 , valor menor do que o encontrado em nosso estudo (52%). O risco de recidiva foi fortemente associado ao câncer de mama TN, colaborando para predizer seu pior prognóstico 20 .…”

Study on epidemiology, risk factors and clinical characteristics of triple negative breast cancer in Bangladesh

“…6,7 The most vulnerable time period for early recurrence in TNBC is first three years after initial treatment with survival rate shorter than in non-TNBC patients. 8 However, there have been recent advancements on novel signalling pathways in the treatment of TNBC patients giving rise to novel chemotherapeutic approaches mostly focusing nano based solution that actively target this particular tumor. Use of agents targeting aberrant DNA repair is under clinical investigation showing a promising result improving the prognosis of the disease.…”