Triple negative breast cancer in Korea-distinct biology with different impact of prognostic factors on survival

Abstract

We analyzed breast cancer subtypes using Korean Breast Cancer Society Registration Program data to compare clinical features and prognosis for triple-negative breast cancer (TNBC). A cohort of 26,767 breast cancer patients were divided in four groups: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+ HER2+), HER2+ (ER-, PR-, HER2+), and triple-negative (ER-, PR-, HER2-). Clinicopathologic factors were evaluated. The luminal A (14,437 patients, 53.9%) subtype was the largest in our study. Compared with luminal A subtype, TNBC correlated with younger age, more aggressive characteristics and poor overall survival and breast cancer-specific survival. The hazard rate showed a peak at 24 months for the TNBC subtype, but after 60 months, risk was similar to that of the luminal A subtype. Higher T, N stage and histologic grade, and lymphatic and vascular invasion showed poor prognosis in TNBC patients, but on multivariate analysis only histologic grade and ki-67 status were related. Young age was related to poor prognosis in the luminal A subtype, however, age was not related to prognosis in the TNBC subtype. Of the 5,586 TNBC patients, 282 patients (7.11%) expired within 3 years of diagnosis. T and N stage and grade were significantly associated with prognosis on multivariate analysis. TNBC subtype is characterized by younger age with poorer outcome. However, younger age is not related to prognosis, and mortality risk decreases to that of the luminal A subtype, which is known to have the best prognosis after a few years.

Syndecan-1 is a potential biomarker for triple-positive breast carcinomas in Asian women with correlation to survival

“…Triple-negative breast cancer has been widely studied and advocated in several studies (16,17) to have a poor prognosis among the various breast cancer subtypes. In contrast, there is limited data on triple-positive breast cancer in the literature.…”

“…In contrast, there is limited data on triple-positive breast cancer in the literature. Although patients with triple-positive breast cancer may benefit from the use of hormonal therapy and immunotherapy -unlike patients with triple-negative breast cancer -triple-positive breast cancer is often not reported as the subtype with the best survival, (16,17) and its survival rate remains unpredictable. Therefore, a prognostic biomarker for triple-positive breast cancer is imperative.…”

A Survey in the Basal Like Breast Carcinoma Phenotype in North East of Iran

“…Compared to other breast cancer patients, the average age of this group is lower and includes more pre-menopause cases (14)(15)(16)(17)(18)(19). However, one study by Iwase reported that triple negative patients were more frequently postmenopausal (16).…”

“…However, one study by Iwase reported that triple negative patients were more frequently postmenopausal (16). Numerous studies indicated that in comparison with other cases, pathological grade of TNTs were higher (13,17,(20)(21)(22)(23) and Ki67 over expression was more common (8,9,14,20,21). In a retrospective cohort study on Korean breast cancer society registration program data, TNBC patients showed higher tumor size, lymphatic stage, histological grade, and more lymphovascular invasion.…”

Triple Negative Status is a Poor Prognostic Indicator in Chinese Women with Breast Cancer: a Ten Year Review

“…Yin and colleagues suggested that the biological behavior and clinical outcome for TNC in Chinese patients may be more favorable than those in Western populations. On the other hand, population-based study from Korea (Lee et al, 2010) commented that it was too early to conclude that clinicopathological features in Asians were unique. In view of paucity of data in Chinese and Asians, we carried out a cohort study on Hong Kong Chinese women with TNC patients.…”