Triple negative breast cancer: an Indian perspective

Abstract

IntroductionBreast cancer is the most common female cancer in the world. Triple negative breast cancer (TNBC) is a recently identified biological variant with aggressive tumor behavior and poor prognosis. Data of hormonal status from the Indian population is scarce due to financial constraints in performing immunohistochemistry evaluation. The present study aims to prospectively analyze receptor status of all breast cancer patients and identify TNBC and compare their clinical profile and short term survival with other non-TNBC group.Materials and methodsAll cytologically and histopathologically confirmed cases of carcinoma breast were prospectively enrolled. In a longitudinal study at tertiary care hospital in central India based on the hormonal status, they were further divided into TNBC and other groups. Comparison of risk factors, clinical profile and short-term survival was carried out.ResultsA total 85 patients were enrolled and of them 37 (43.7%) were TNBC. On comparing risk factors ie, age, age at menarche, total reproductive age, age at first child birth, and menopausal status – no statistical significance was observed between the TNBC and non-TNBC groups. But on comparison of clinical profile TNBC tumors were significantly large with majority of patients presenting as locally advanced breast cancer (83%). No statistical difference was observed in axillary lymph node status between two groups. TNBC tumors were histologically more aggressive (grade 3) compared to other groups. No statistically significant difference was observed in short term overall survival but all three deaths were observed in the TNBC group only and two local recurrences after surgery were observed in the TNBC group.ConclusionTNBC forms a large proportion of carcinoma breast patients in a central Indian scenario and needs more research to identify appropriate treatment planning considering aggressive histology and advanced presentation.

Are Basal-Like and Non-Basal-Like Triple-Negative Breast Cancers Really Different?

“…We found 22% of total breast cancer cases as TNBC which has a similar incidence to that reported in some Indian studies [12,13]. However, many Indian studies have reported higher TNBC prevalence such as 39.8% and 43.5% [5,14]. akur et al [15]…”

“…TNBC contributes to a large proportion of breast cancer deaths despite its small proportion among all breast cancers. Prevalence of TNBC in India is considerably higher compared with Western populations [4,5]. e recent literature reports an exceptionally high frequency of TNBC (73.9%) in Indian premenopausal women below 35 years of age, in the prime of their reproductive life [6].…”

A Survey on Breast Cancer Awareness Among Medical, Paramedical, and General Population in North India Using Self-Designed Questionnaire: a Prospective Study

“…Breast cancer incidence is growing in both developed and less developed countries; however, there are more deaths due to BC in less developed countries [5]. There are many factors responsible for increased mortality due to BC in resource-limited countries like younger age of presentation, more locally advanced BC stage, more triple-negative BC, more aggressive histology and higher grades of the tumor, patients defaulting and not completing whole treatment or total number of chemotherapies due to poverty/toxicities, money problems, and going for alternative methods of medicine like homeopathy [6].…”

Epidemiology of breast cancer in Indian women

“…Prevalence of TNBC in India is considerably higher compared with that seen in Western populations as suggested by various meta‐analysis studies . TNBC tumors are significantly larger with majority of patients presenting as locally advanced stage breast cancer which is histologically more aggressive (grade 3) compared to other groups . Survival studies have revealed the fact that two‐third of patients at time of disease presentation are in advanced‐stage which account for the poor overall survival .…”