Triple-Negative Breast Cancer (TNBC)

Main Article Content

ปองทิพย์ อุ่นประเสริฐ ภาคภูมิ บำรุงราชภักดี พุฒิศักดิ์ พุทธวิบูลย์

Abstract

Background Triple-negative breast cancer (TNBC) (estrogen receptor-negative, progesterone
receptor-negative, and HER2-negative) is a high risk breast cancer due to its aggressive behavior
and nature of high recurrence.
Objective To determine the risk factor for recurrence and to determine the clinical features
in patients with TNBC.
Material and Methods The retrospective data from Songklanagarind Hospital was conducted
between September 1st, 2006, and August 31st, 2009, and identified patients with TNBC. The
study then characterized this specific subgroup of breast cancer according to risk factors: age,
family history, clinical manifestations, detection methods, tumor size, tumor grading, lymph
node status, extensive intraductal component (EIC), lymphovascular invasion (LVI), resection
margin and systemic therapy, to estimate the recurrence of TNBC.
Results 98.75% of our eighty (80) patients diagnosed with TNBC (mean age 50.9 years with an age
range between 28-79 years old), presented breast masses – of which 64% had grade 3 tumors. Of
those grade 3 tumors, 73.7% were more than 2 centimeters in size. Further, 30% had an invasive
intraductal component, 56.25% were nodal status positive and 38.75% had lymphovascular
invasion. The presence of lymphovascular invasion showed a significant statistical factor in the
recurrence of TNBC patients (an odds ratio of 4.17, 95% CI : 1.5183 - 11.4343, p = 0.0056).
Conclusions The present study shows the status of lymphovascular invasion as the significant
risk factor for recurrence of TNBC in patients.

Keywords

Article Details

Section
Original article

References

1. Rakha EA, Ellis IO. Triple-negative/basal-like
breast cancer: review. Pathology. 2009;
41: 40-7.

2. Dawood S, Broglio K, Kau SW, Green
MC, Giordano SH, Meric-Bernstam F, et
al. Triple receptor-negative breast cancer:
the effect of race on response to primary
systemic treatment and survival outcomes.
J Clin Oncol. 2009; 27: 220-6.

3. Rakha EA, El-Sayed ME, Green AR, Lee
AH, Robertson JF, Ellis IO. Prognostic
markers in triple-negative breast cancer.
Cancer. 2007; 109: 25-32.

4. Tan DS, Marchió C, Jones RL, Savage K,
Smith IE, Dowsett M, et al. Triple negative
breast cancer: molecular profiling
and prognostic impact in adjuvant
anthracycline-treated patients. Breast
Cancer Res Treat. 2008; 111: 27-44.

5. Matkovic B, Juretic A, Separovic V, Novosel
I, Separovic R, Gamulin M, et al.
Immunohistochemical analysis of ER,
PR, HER-2, CK 5/6, p63 and EGFR antigen
expression in medullary breast cancer.
Tumori. 2008; 94: 838-44.

6. Nofech-Mozes S, Trudeau M, Kahn HK, Dent
R, Rawlinson E, Sun P, et al. Patterns, of
recurrence in the basal and non-basal
subtypes of triple-negative breast cancers.
Breast Cancer Res Treat. 2009; 118: 131-7.

7. Carey LA, Rugo HS, Marcom PK, Mayer
EL, Esteva FJ, Ma CX, et al. TBCRC 001:
EGFR inhibition with cetuximab added to
carboplatin in metastatic triple-negative
(basal-like) breast cancer. J Clin Oncol.
2008; 8: 178-86.

8. Dent R, Trudeau M, Pritchard KI, Hanna
WM, Kahn HK, Sawka CA, et al. Triplenegative
breast cancer: Clinical features
and patterns of recurrence. Clin Cancer
Res. 2007; 13: 4429-34.

9. Ovcaricek T, Frkovic SG, Matos E, Mozina
B, Borstnar S. Triple negative breast
cancer – prognostic factors and survival.
Radiol Oncol. 2011; 45: 46-52.

10. Collett K, Stefansson IM, Eide J, Braaten
A, Wang H, Eide GE, et al. A basal epithelial
phenotype is more frequent in interval
breast cancers compared with screen
detected tumors. Cancer Epidemiol
Biomarkers Prev. 2005; 14: 1108-12.

11. Liedtke C, Mazouni C, Hess KR, André
F, Tordai A, Mejia JA, et al. Response
to neoadjuvant therapy and long-term
survival in patients with triple-negative
breast cancer. J Clin Oncol. 2008; 26:
1275-81.

12. Banerjee S, Reis-Filho JS, Ashley S, Steele
D, Ashworth A, Lakhani SR, et al. Basal-like
breast carcinomas: clinical outcome and
response to chemotherapy. J Clin Pathol.
2006; 59: 729-35.