Binitha Tresa Thomas1, Preeya Vasanthakumary2, Ancy Joseph3
BACKGROUND
Breast cancer is now the most common cancer in Indian women, having recently
surpassed cervical cancer in incidence. Triple negative breast cancer (TNBC),
which accounts for 15 % of all the breast cancers is an aggressive type seen in
younger women with early signs of metastasis, has a poor prognosis due to
systemic recurrence and its refractoriness to conventional adjuvant therapy. The
purpose of this study was to look into the various prognostic factors associated
with 5 years disease-free survival (DFS) and overall survival (OS) in TNBC.
METHODS
This retrospective study included 67 patients with complete treatment and followup
(median 57 months) presented and treated in the Department of Radiotherapy,
Kottayam, between January 2011 and December 2012. The Kaplan-Meier
approach was used to analyse survival. Using the log-rank test, univariate analysis
of prognostic factors was completed. Using the Cox regression process,
multivariate analysis was performed on IBM SPSS version 20.
RESULTS
The average age was 51.36 ± 11.393 (median, 51.36 years; range 30.0 – 80.0
years), with a median of 50 months, the five-year OS was 65.7 % and DFS was
found to be 59.7 % with a median of 45 months, suggesting aggressive nature
and poor TNBC survival. Univariate analysis of prognostic factor, clinical stage (cN)
and positive nodes (pN) status, clinical tumour size, lympho-vascular invasion
(LVI), grade, and nodal density were found to have a significant impact on DFS.
Except tumour grade and LVI all were found to be associated with OS. Multivariate
analysis, clinical tumour size and pathological nodal status had a significant impact
on OS and DFS.
CONCLUSIONS
TNBC is an aggressive subtype of breast cancer in younger patients with a high
risk of metastasis to visceral organs with inherent molecular subtypes and
immunological heterogeneity. For treatment of TNBC, targeted estimated
glomerular filtration rate (EGFR), fibroblast growth factor receptor 2 (FGFR2),
vascular endothelial growth factor (VEGF), and mechanistic target of rapamycin
(mTOR) receptor based initial treatment setting will improve the outcome
dramatically and will fill the unmet clinical needs.
