Jayaraman KANNAN, Srigopal MOHANTY, Amit SAKLANI, Deepak GEORGE, Natarajan INGERSAL

Pattern of Recurrence and Survival Outcomes in Non-Metastatic Triple-Negative Breast Cancer; A Retrospective Analysis

OBJECTIVE Triple-negative breast cancer (TNBC) is an aggressive heterogeneous cancer and carries poor prognosis. The study was conducted to analyze the recurrence pattern and survival outcome in TNBC patients. METHODS A retrospective analysis was performed for 171 consecutive non-metastatic TNBC patients. Chi-square test, Kaplan-Meier method, and Cox-regression analysis were used for statistical analysis. P nodes (regional+non regional) > brain > bone > liver > contralateral breast. The disease-free survival (DFS) and overall survival (OS) were 64.3% and 78.4%, respectively. High-grade tumor, nodal metastasis,

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1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjo- mataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71(3):209–49.
2. Mathur P, Sathishkumar K, Chaturvedi M, Das P, Sudarshan KL, Santhappan S, et al; ICMR-NCDIR- NCRP Investigator Group. Cancer statistics, 2020: re- port from national cancer registry programme, India. JCO Glob Oncol 2020;6:1063–75.
3. Yersal O, Barutca S. Biological subtypes of breast can- cer: Prognostic and therapeutic implications. World J Clin Oncol 2014;5(3):412–24.
4. Rivenbark AG, O’Connor SM, Coleman WB. Molec- ular and cellular heterogeneity in breast cancer: challenges for personalized medicine. Am J Pathol 2013;183(4):1113–24.
5. Tsang JYS, Tse GM. Molecular classification of breast cancer. Adv Anat Pathol 2020;27(1):27–35.
6. Eliyatkın N, Yalçın E, Zengel B, Aktaş S, Vardar E. Molecular classification of breast carcinoma: from tra- ditional, old-fashioned way to a new age, and a new way. J Breast Health 2015;11(2):59–66.
7. Garmpis N, Damaskos C, Garmpi A, Nikolettos K, Dimitroulis D, Diamantis E, et al. Molecular classifica- tion and future therapeutic challenges of triple-nega- tive breast cancer. In Vivo 2020;34(4):1715–27.
8. Yin L, Duan JJ, Bian XW, Yu SC. Triple-negative breast cancer molecular subtyping and treatment progress. Breast Cancer Res 2020;22(1):61.
9. Lehmann BD, Pietenpol JA. Identification and use of biomarkers in treatment strategies for triple-negative breast cancer subtypes. J Pathol 2014;232(2):142–50.
10. Giuliano AE, Edge SB, Hortobagyi GN. Eighth edition of the AJCC cancer staging manual: breast cancer. Ann Surg Oncol 2018;25(7):1783–5.
11. Qiu J, Xue X, Hu C, Xu H, Kou D, Li R, et al. Compar- ison of clinicopathological features and prognosis in triple-negative and non-triple negative breast cancer. J Cancer 2016;7(2):167–73.
12. Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, et al. Triple-negative breast can- cer: clinical features and patterns of recurrence. Clin Cancer Res 2007;13(15 Pt 1):4429–34.
13. Haffty BG, Yang Q, Reiss M, Kearney T, Higgins SA, Wei- dhaas J, et al. Locoregional relapse and distant metasta- sis in conservatively managed triple negative early-stage breast cancer. J Clin Oncol 2006;24(36):5652–7.
14. Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V. Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-nega- tive invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the Califor- nia cancer Registry. Cancer 2007;109(9):1721–8.
15. Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K, et al. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA 2006;295(21):2492–502.
16. Morris GJ, Naidu S, Topham AK, Guiles F, Xu Y, McCue P, et al. Differences in breast carcinoma char- acteristics in newly diagnosed African-American and Caucasian patients: a single-institution compi- lation compared with the National Cancer Institute’s Surveillance, Epidemiology, and End Results database. Cancer 2007;110(4):876–84.
17. Doval DC, Radhakrishna S, Tripathi R, Kashinath RI, Talwar V, Batra U, et al. A multi-institutional real world data study from India of 3453 non-metastatic breast cancer patients undergoing upfront surgery. Sci Rep 2020;10(1):5886.
18. Pogoda K, Niwińska A, Murawska M, Pieńkowski T. Analysis of pattern, time and risk factors influencing recurrence in triple-negative breast cancer patients. Med Oncol 2013;30(1):388.
19. Dietze EC, Sistrunk C, Miranda-Carboni G, O’Re- gan R, Seewaldt VL. Triple-negative breast cancer in African-American women: disparities versus biology. Nat Rev Cancer 2015;15(4):248–54.
20. Ghosh J, Agarwal S, Ganguly S, Debkara D, Biswas B, Nandi S, et al. Patterns of recurrence in triple negative breast cancer patients (automated IHC): an Indian ter- tiary care center data. J Clin Oncol 2018;36(15):suppl– e13128.
21. Chen H, Wu J, Zhang Z, Tang Y, Li X, Liu S, et al. Association between BRCA status and triple-nega- tive breast cancer: a meta-analysis. Front Pharmacol 2018;9:909.
22. Bianchini G, Balko JM, Mayer IA, Sanders ME, Gianni L. Triple-negative breast cancer: challenges and op- portunities of a heterogeneous disease. Nat Rev Clin Oncol 2016;13(11):674–90.
23. Alluri P, Newman LA. Basal-like and triple-negative breast cancers: searching for positives among many negatives. Surg Oncol Clin N Am 2014;23(3):567–77.
24. Fayaz MS, El-Sherify MS, El-basmy A, Zlouf SA, Nazmy N, George T, et al. Clinicopathological fea- tures and prognosis of triple negative breast cancer in Kuwait: A comparative/perspective analysis. Reports Pract Oncol Radioth 2014;19(3):173–81.
25. Plasilova ML, Hayse B, Killelea BK, Horowitz NR, Chag- par AB, Lannin DR. Features of triple-negative breast cancer: Analysis of 38,813 cases from the national can- cer database. Medicine (Baltimore) 2016;95(35):e4614.
26. Steward L, Conant L, Gao F, Margenthaler JA. Pre- dictive factors and patterns of recurrence in patients with triple negative breast cancer. Ann Surg Oncol 2014;21(7):2165–71.
27. Lin NU, Claus E, Sohl J, Razzak AR, Arnaout A, Winer EP. Sites of distant recurrence and clinical outcomes in patients with metastatic triple-negative breast cancer: high incidence of central nervous system metastases. Cancer 2008;113(10):2638–45.
28. Eralp Y, Kılıç L, Alço G, Başaran G, Doğan M, Dinçol D, et al. The outcome of patients with triple negative breast cancer: The Turkish Oncology Group Experi- ence. J Breast Health 2014;10(4):209–15.
29. MousaviSA,KasaeianA,PourkasmaeeM,Ghavamzadeh A, Alimoghaddam K, Vaezi M, et al. Assessing the prognostic factors, survival, and recurrence incidence of triple negative breast cancer patients, a single center study in Iran. PLos One 2019;14(1):e0208701.