scholarly journals Patterns of Failure in triple negative breast cancer patients in an urban, predominately black population

2019 ◽  
Author(s):  
Hua-Ren Cherng ◽  
Stephanie R Rice ◽  
Muhammad Hamza ◽  
Shruti Murali ◽  
Paula Rosenblatt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Failure ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Smoking Status ◽  
Univariate Analysis ◽  
Breast Cancer Patients ◽  
Patterns Of Failure ◽  
Failure Patterns

Abstract Background: We sought to evaluate the comprehensive patterns of failure associated with treatment for triple negative breast cancer (TNBC) at a single urban institution. Methods: A retrospective review of TNBC patients treated from 2005-2015 was conducted. Detailed patient, tumor and treatment characteristics were included. Information on patterns of treatment failure, including local, regional, distant and combinations of these three were collected. Chi-square testing was used to compare variables, while logistic regression with Kaplan-Meier estimate was used to calculate overall survival (OS) and freedom from recurrence (FFR). Results: With a median follow-up of 46 months, 32 (16%) documented failures occurred. Locoregional failures comprised 84% of failure patterns whether isolated or in combination with distant failure. 5-year OS and FFR were 76.4% and 83.8%, respectively. On univariate analysis, treatment failure was associated with insurance type, smoking status, presence of LVSI, clinical detection of tumor, increasing clinical tumor size (>2 cm), and increasing pathologic tumor stage, nodal stage, and overall staging. On multivariate analysis, pathologic nodal staging was the most significant predictor of treatment failure. Conclusion: Our work shows that with modern therapies, treatment outcomes for patients with TNBC are very good. 53% of patients failed in distant and locoregional sites simultaneously, with an additional 34% failing locally only. These results highlight the need for aggressive local therapies in high-risk patients as well as suggest a need for improved follow up care focusing on detecting locoregional failures. Integrated multidisciplinary care is essential in the management of these patients at time of failure. Keywords: Triple negative, breast cancer, failure, patterns, predictors

Breast cancer in young women in India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11506-e11506
Author(s):  
Sanjay P Deshmukh ◽  
Anupama Dutt Mane
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Care Center ◽  
Tumour Size ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
P Value ◽  
Breast Cancer Patients ◽  
Women In India

e11506 Background: The incidence of breast cancer is rising in India. It presents at a younger age in Indian population as compared to the western countries. Methods: This is a retrospective review of all breast cancer patients less than 40 years of age treated in single tertiary care center from June 2006 to June 2011. The aim was to assess the factors that may influence clinical outcome and prognosis including demographics, clinical characteristics, surgical and pathological findings and the treatment given. Clinical data was collected from medical records and histopathology reports. Independent variables like age, stage at presentation, surgery type, chemotherapy, radiation, tumour size, grade, nodal status, no. of positive nodes, perinodal extension, lymphovascular extension, ER, PR and Her2 neu were analysed. Results: Out of a total of 613 patients, 91 were under 40 years of age, corresponding to a prevalence of 14.8%. Median age was 35 years with the youngest being 23 years old. Maximum patients were in the age group of 36-40 years. Lymphovascular emboli was positive in 42 patients (48.8%) and perinodal extension was positive in 36 patients (41.8%). 30 patients(34.8%) had ER positivity, while 39 patients (45.3%) had PR positivity. Her 2 neu receptors were positive in 20 patients (23.2%). 39 patients were triple negative (45.3%). The median follow up period for all the patients was 28 months with the DFS being 76.1% and OS being 88.3%. In univariate analysis, factors significantly associated with survival were stage at presentation (p value- 0.026), presence of lymhovascular emboli (p value- 0.019) and presence of perinodal extension (p value- 0.007 ).Grade of the tumour also correlated with survival , however it was not statistically significant (p value- 0.086). Statistical analysis was done with SPSS 17. Conclusions: The incidence of breast cancer in younger women in India is high with increased number of triple negative patients. Overall survival is quite similar to that of the western population. Longer follow up and more studies are required to confirm this finding.

scholarly journals Impact of estrogen receptor levels on outcome in non-metastatic triple negative breast cancer patients treated with neoadjuvant/adjuvant chemotherapy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Maria Vittoria Dieci ◽  
Gaia Griguolo ◽  
Michele Bottosso ◽  
Vassilena Tsvetkova ◽  
Carlo Alberto Giorgi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Complete Response ◽  
Breast Cancer Patients ◽  
Significant Difference ◽  
Neo Adjuvant Chemotherapy

AbstractAlthough 1% is the recommended cut-off to define estrogen receptor (ER) positivity, a 10% cut-off is often used in clinical practice for therapeutic purposes. We here evaluate clinical outcomes according to ER levels in a monoinstitutional cohort of non-metastatic triple-negative breast cancer (BC) patients undergoing (neo)adjuvant chemotherapy. Clinicopathological data of 406 patients with ER < 10% HER2-negative BC treated with (neo)adjuvant chemotherapy between 01/2000 and 04/2019 were collected. Patients were categorized in ER-negative (ER < 1%; N = 364) and ER-low positive (1–9%, N = 42). At a median follow-up of 54 months, 88 patients had relapsed and 64 died. No significant difference was observed in invasive relapse-free survival (iRFS) and overall survival (OS) according to ER expression levels, both at univariate and multivariate analysis (5-years iRFS 74.0% versus 73.1% for ER-negative and ER-low positive BC, respectively, p = 0.6; 5-years OS 82.3% versus 76.7% for ER-negative and ER-low positive BC, respectively, p = 0.8). Among the 165 patients that received neoadjuvant chemotherapy, pathological complete response rate was similar in the two cohorts (38% in ER-negative, 44% in ER-low positive, p = 0.498). In conclusion, primary BC with ER1–9% shows similar clinical behavior to ER 1% BC. Our results suggest the use of a 10% cut-off, rather than <1%, to define triple-negative BC.

scholarly journals Prognostic Value of HER2-Low Expression in Non-Metastatic Triple-Negative Breast Cancer and Correlation with Other Biomarkers

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6059
Author(s):  
William Jacot ◽  
Aurélie Maran-Gonzalez ◽  
Océane Massol ◽  
Charlotte Sorbs ◽  
Caroline Mollevi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Prognostic Value ◽  
Triple Negative ◽  
Histological Grade ◽  
Univariate Analysis ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Few Data

HER2-low breast cancer (i.e., HER 1+ or 2+, without gene amplification) is an emerging subtype for which very few data are available, especially within the triple-negative breast cancer (TNBC) group. Our aim was to evaluate HER2 expression and its prognostic value in a large retrospective series of patients with non-metastatic TNBC (median age: 57.7 years; range: 28.5–98.6). Among the 296 TNBC samples, 83.8% were HER2 0, 13.5% were HER2 1+, and 2.7% were HER2 2+ (HercepTestTM and 2018 ASCO/CAP guidelines for HER2 scoring). CK5/6 and/or EGFR-expressing androgen receptors and FOXA1-expressing tumors were classified as basal-like (63.8%) and molecular apocrine-like (MA, 40.2%), respectively. Compared with HER2 0 tumors, HER2 1+/2+ tumors exhibited a lower histological grade (1/2) (35.4% vs. 18.2%, p = 0.007) and MA profile (57.5% vs. 36.7%, p = 0.008). Moreover, patients with HER2 1+/2+ tumors were older (p = 0.047). After a median follow-up of 9.7 years, HER2 2+ tumors (compared with HER2 0/1+ tumors) were associated with worse relapse-free survival (RFS) (HR = 3.16, 95% CI [1.27; 7.85], p = 0.034) in a univariate analysis. Overall survival (OS) and RFS were not different in the HER2 0 and 1+/2+ groups. HER2 levels were not significantly associated with OS or RFS in a multivariate analysis.

Upfront stereotactic radiosurgery for brain metastases from triple-negative breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e14014-e14014
Author(s):  
Ran An ◽  
Yan Wang ◽  
Fuchenchu Wang ◽  
Akshara Singareeka Raghavendra ◽  
Chao Gao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Univariate Analysis ◽  
Karnofsky Performance Score ◽  
Risk Of Death

e14014 Background: Triple-negative breast cancer (TNBC) is an aggressive subtype with high propensity of brain metastases (BM). Outcomes after upfront stereotactic radiosurgery (SRS) for BM from TNBC patients are not well defined. We evaluated outcomes and identified prognostic factors for such patients. Methods: We reviewed 57 consecutive patients treated with upfront SRS for BM from TNBC in May 2008–April 2018 at a large-volume cancer center. Endpoints were overall survival (OS) from BM diagnosis and freedom from BM progression (FFBMP) after initial SRS. BM progression was defined as local and/or distant brain failure (LBF or DBF) after initial SRS; LBF was radiographic progression of treated lesions, assessed by a neuroradiologist or treating physician excluding post-radiation changes or radiation necrosis. Kaplan-Meier and Cox proportional hazard regression analyses were used to estimate survival outcomes and identify prognostic factors. Results: In this cohort of 57 patients with a median age of 53 y (range 26–82) at BM diagnosis and follow-up time of 12.2 months (mo, range 0.8–97.5), median time to BM development from TNBC diagnosis was 23.7 mo (range 0.7‒271.1). Estimated median OS time from initial BM diagnosis was 13.1 mo (95% CI 8.0‒19.5). In univariate analysis, Karnofsky performance score (KPS) > 70 (p = 0.03), having < 3 BMs (p = 0.016) at BM diagnosis, and BM as first site of metastasis (p = 0.041) were associated with longer OS. On multivariate analysis, KPS ≤70 was associated with higher risk of death (HR 3.0, p = 0.03). Of 46 patients with imaging follow-up for FFBMP assessment, 29 (63%) developed BM progression after initial SRS with an estimated median FFBMP of 7.4 mo (95% CI 5.7–12.7). Median times to LBF and DBF were 10 mo (range 0.3–97) and 5.9 mo (range 0.3–90.8). Estimated cumulative LBF rate was 17.8% (95% CI 2%–31.1%) and DBF 61.1% (95% CI 40.8%–74.4%) at 12 mo. Number of BMs at BM diagnosis (≥3 vs < 3) was not associated with FFBMP (p = 0.7). Of the 29 patients with BM progression, 5 did not receive salvage radiation therapy (RT) and 24 received salvage RT (SRS, whole-brain radiation [WBRT], or both SRS+WBRT). Receipt of salvage RT was associated with longer survival (median 21.7 mo vs. 7.0 mo for no salvage RT, p < 0.0001) and did not differ by type of salvage RT (median OS 18.6 mo for WBRT; 26.2 mo for SRS+WBRT; 35.9 mo for SRS, p = 0.08). Conclusions: We reported a median OS of 13.1 mo and FFBMP of 7.4 mo in TNBC patients with good local control. Good KPS was independent prognostic factor for better OS. FFBMP did not differ by number of SRS-treated brain lesions ( < 3 vs ≥3). Further prospective studies of larger numbers of patients needed for more accurate comparisons of treatment types.

scholarly journals A 10-year Follow-up of Triple-negative Breast Cancer Patients in Taiwan

2012 ◽  
Vol 42 (3) ◽  
pp. 161-167 ◽  
Author(s):  
C. Lin ◽  
S.-Y. Chien ◽  
S.-J. Kuo ◽  
L.-S. Chen ◽  
S.-T. Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Breast Cancer Patients

Comparison of serum levels of CEA and CA 15–3 in triple-negative breast cancer at the time of metastases and serum levels at the time of first diagnosis

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e12017-e12017
Author(s):  
D. Sener Dede ◽  
S. Aksoy ◽  
N. Bulut ◽  
O. Dizdar ◽  
Z. Arik ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Serum Levels ◽  
Breast Cancers ◽  
Negative Group ◽  
Breast Cancer Patients ◽  
Serum Cea

e12017 Background: Cancer antigen 15–3 (CA 15–3) and carcinoembryonic antigen (CEA), are often used in follow up care of breast cancer and provide important clues to the clinicians for disease progression in metastatic and recurrent breast cancer. Triple-negative breast cancers are frequently defined as a single group identifiable using routine clinical tests. They are negative for estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER-2), the so-called triple-negative breast cancers. In this study we compared the tumor markers of triple negative breast cancer and non-triple negative patients. Methods: We retrospectively analyzed serum CEA and CA 15–3 levels of both triple negative and non-triple negative breast cancer patients at the time of first diagnosis and when they developed metastatic disease. Results: 544 consecutive nonmetastatic breast cancer patients presenting at Hacettepe University Institute of Oncology, Ankara, Turkey, with a median age of 49 were evaluated. 15.1% of the patients were triple negative breast cancer. At the time of diagnosis triple negative group had lower serum CEA (2.5 ± 5.9 vs 4.0 ±16.4 p = 0.35) and CA 15–3 (23.7 ± 14.6 vs 37.1 ± 117; p = 0.021) levels compared to non-triple negative group. In patients who developed metastasis during follow up; the CEA (3.2 ± 3.8 vs 29.6 ± 106.4 p = 0.022) and CA15–3 (46.9 ± 46.3 vs 203.2 ± 534 p = 0.008) levels were also significantly lower in triple negative breast cancer group compared to non-triple negative group.In non-triple negative breast cancer patients who developed metastasis, mean serum levels of CEA and CA15–3 significantly increased compared to baseline, whereas in triple negative group who developed metastasis CEA and CA 15–3 levels did not differ significantly. Conclusions: While being a good laboratory parameter in the follow-up of patients with breast cancer metastases, tumor markers may not show the increased tumor burden in the triple-negative breast cancer patients. No significant financial relationships to disclose.

Clinical and pathological characteristics of triple-negative breast cancer patients: A single-center experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11515-e11515
Author(s):  
Aydan Akdeniz ◽  
Selim Yalcin ◽  
Samed Rahatli ◽  
Nadire Kucukoztas ◽  
Mahmut Can Yagmurdur ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
University Hospital ◽  
High Grade ◽  
Breast Cancer Patients ◽  
Pathological Characteristics ◽  
Younger Age

e11515 Background: Triple negative breast cancer in which estrogen, progesterone receptors and c-erbB2 overexpression are negative, seems to have different clinical course and recurrence pattern. Methods: We evaluated retrospectively clinical demographic and pathological characteristics of triple negative breast cancers and investigated the association of these characteristics with OS and PFS. Results: 59 early stage patients with triple negative breast cancer patients followed in Baskent University Hospital between 1997-2009 were enrolled into the study. The median age of patients was 49. Median follow-up duration was 27 months (0.27-132 months). Two patients died during the follow-up. Invasive ductal carcinoma pathology was reported in 38 patients, invasive lobular in 3 patients, medullary in 5 patients.Almost half of the patients had LVI. 79% of patients had a T2 disease. 30% of patients’ tumor histological grade was III. Cancer history in the family was present in 95% of patients. Almost half of the patients had stage II disease. Adjuvant chemotherapy was given to 43 patients. Relapses were observed in 15 patients.The most common metastatic site was lung. Patients having high grade tumor, >3 (+) lymph nodes, younger age have higher chance of relapse during follow-up. Conclusions: In accordance with the literature, our triple negative breast cancer patients showed more aggressive characteristics. Although median follow-up is short, one-fourth of the patients having recurrence support natue of the triple negative breast cancer patients. In our study, triple negative patients had younger age at diagnosis, high grade tumors and more tendency to metastasize to visceral organs.

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