TITLE:
Early Stage Triple Negative Breast Cancer Has Significantly Better Outcomes than More Advanced Disease: A Single Centre Retrospective Review
AUTHORS:
Caroline Hamm, Swati Kulkarni, Rasna Gupta, Amin Kay, John Mathews, Khalid Hirmiz, Indryas Woldie, Akmal Ghafoor, Tarek Elfiki, Sindu Kanjeekal, Ming Pan, Kenneth Schneider, Junaid Yousuf, Mohammad Jarrar, Colvin Springer, Maher El-Masri
KEYWORDS:
Triple Negative Breast Cancer, Prognostic Factors, Stage
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.10,
September
22,
2016
ABSTRACT: A
retrospective, serial analysis of 181 triple negative breast cancer (TNBC)
patients was undertaken at a regional cancer centre in Canada. The primary
focus of the analysis was to investigate the effect of presenting stage in
patients with TNBC on progression free and overall survival. We were
able to demonstrate that patients presenting with an earlier stage breast
cancer had a significantly superior progression free and overall survival when
compared to more advanced stage. The adjusted multivariate cox-regression
analyses for the overall and progression free survival suggest that the hazard
of death was significantly lower for patients with stages I (HR = 0.09; 95%
CI 0.03
- 0.24)
and II (HR = 0.29;
95% CI 0.16
- 0.54)
than for patients with stage III. The only
other predictor of progression free survival besides stage, was receipt of radiotherapy
(HR = 0.39;
95% CI 0.22
- 0.69)
in the adjusted cox regression analysis. Less than
2% of patients presented with stage IV disease. The small numbers presenting with
stage IV disease may have impact on the development of clinical and translational
trials. Certainly there may be stage migration if staging included more
standardized or more sensitive investigations such as PET scans, and this might
an important consideration in developing clinical trials. Twenty-five
percent of patients presented with stage I disease. It is important for
patients with TNBC presenting with earlier stages of disease that they are
aware that they will have a better prognosis than their counterparts with more
advanced disease. It is important that we are
aware of this patient population, as their treatment recommendations are
unclear and a source of a fair amount of controversy currently.