Nodal Status and Clinical Outcomes in a Large Cohort of Patients With Triple-Negative Breast Cancer

Abstract

A B S T R A C T PurposeTo evaluate the clinical outcomes and relationship between tumor size, lymph node status, and prognosis in a large cohort of patients with confirmed triple receptor-negative breast cancer (TNBC). Patients and MethodsWe reviewed 1,711 patients with TNBC diagnosed between 1980 and 2009. Patients were categorized by tumor size and nodal status. Kaplan-Meier product limit method was used to calculate overall survival (OS) and relapse-free survival (RFS). A Sidak adjustment was used for multiple group comparisons. Cox proportional hazards models were fit to determine the association of tumor size and nodal status with survival outcomes after adjustment for other patient and disease characteristics. ResultsMedian age was 48 years (range, 21 to 87 years). At a median follow-up of 53 months (range, 0.7 to 317 months), there were 614 deaths and 747 recurrences. The 5-year OS was 80% for node-negative patients (N0), 65% for one to three positive lymph nodes (N1), 48% for four to nine positive lymph nodes (N2), and 44% for Ն 10 positive lymph nodes (N3; P Ͻ .0001). The 5-year RFS rates were 67% for N0, 52% for N1, 36% for N2, and 33% for N3 (P Ͻ .0001). Pairwise comparison by nodal status showed that when comparing N0 with node-positive disease, there was a significant difference in OS and RFS (P Ͻ .001 all comparisons). However, when comparing N1 with N2 and N3 disease regardless of tumor size, there were no significant differences in OS or RFS. ConclusionIn patients with TNBC, once there is evidence of lymph node metastasis, the prognosis may not be affected by the number of positive lymph nodes.

Influencing the Tumor Microenvironment: A Phase II Study of Copper Depletion Using Tetrathiomolybdate in Patients with Breast Cancer at High Risk for Recurrence and in Preclinical Models of Lung Metastases

“…This is particularly encouraging because the median overall survival of stage IV TNBC is 13 months in multiple large datasets and the median overall survival in our study has not been reached. Similarly, the median overall survival for stage III TNBC is less than 40% at 4 years in most large datasets and in our cohort appears to be longer although a randomized trial is necessary to confirm this exploratory observation (40,48).…”

Prognostic analysis of triple-negative breast cancer patients treated with adjuvant chemotherapy of fluorouracil, epirubicin and cyclophosphamide

“…In the present study, the general disease progression rate is 12.1% (29/239, the local recurrence rate is 6.7% (16/239) and the distant metastasis rate is 8.8% (21/239). These findings suggest that distant metastasis may exhibit a certain organ tendency in TNBC (23)(24)(25) and that the specific target organ metastasis may be associated with specific gene expression (26)(27)(28). Dent et al observed that the frequency of distant metastasis was significantly increased among patients with TNBC compared with non-TNBC patients (33.9 and 22.4%, respectively), and the risk of distant metastasis was found to be increased in the TNBC group (relative risk = 2.6) (18).…”

Identification of multi-target effects of Huaier aqueous extract via microarray profiling in triple-negative breast cancer cells

“…Management of TNBC is a challenge due to lack of targeted therapy, aggressive tumor behavior and relatively poor prognosis (29). Although it has been reported that TNBC was chemosensitive, the results remained unsatisfactory (30)(31)(32)(33). Maximal effort should be made to select the best possible drugs for effective maintenance treatment of TNBC.…”