Division of Hematology-Oncology, Department of Medicine.
Department of Pathology.
Ann Oncol. 2011 Jul;22(7):1554-1560. doi: 10.1093/annonc/mdq617. Epub 2011 Jan 17.
There has been reported that the association between nodal spread and tumor size was disrupted in triple-negative breast cancer (TNBC) and it showed characteristically early relapse. The TNM (tumor-node-metastasis) staging system might not be equally effective as a prognostic indicator for all subtypes. The aim of our study was to evaluate the usefulness of the staging according to subtypes.
We conducted a retrospective analysis of invasive breast cancer patients who received curative surgery at Samsung Medical Center from 2000 to 2004. Relapse-free survivals (RFS) by stage were analyzed.
Thousand eight hundred and seventy-nine patients who were available clinicopathologic data were included. These patients were divided into three subtypes: hormone receptor (HR)+, human epidermal growth factor receptor 2+, and triple negative groups. As the stage became more advanced, the slope of each stage of the RFS curves of patients with HR+ and HER2+ steadily increased. In contrast, RFS curves intermingled and showed overlap from stage 1 to 3A in TNBC patients. There was only wide separation of RFS curves between stage 1-3A and 3B-3C in TNBC.
The current TNM staging system might not be enough for encompassing the tumor biology and for predicting outcomes to make therapeutic decisions for all BCs, especially for TNBC patients.
有报道称，三阴性乳腺癌（TNBC）中淋巴结转移与肿瘤大小之间的关联被打破，其表现出明显的早期复发。TNM（肿瘤-淋巴结-转移）分期系统可能不能作为所有亚型的同等有效预后指标。我们的研究目的是评估根据亚型进行分期的有用性。
我们对 2000 年至 2004 年在三星医疗中心接受根治性手术的浸润性乳腺癌患者进行了回顾性分析。分析了按分期的无复发生存率（RFS）。
纳入了 1879 例具有完整临床病理数据的患者。这些患者被分为三种亚型：激素受体（HR）阳性、人表皮生长因子受体 2 阳性和三阴性组。随着分期的进展，HR+和 HER2+患者各分期 RFS 曲线的斜率逐渐增加。相比之下，TNBC 患者的 RFS 曲线从 1 期到 3A 期相互交织并重叠。只有在 TNBC 中，1-3A 期和 3B-3C 期之间的 RFS 曲线才有明显的分离。
目前的 TNM 分期系统可能不足以涵盖肿瘤生物学，并预测所有乳腺癌患者的治疗结果，特别是 TNBC 患者。
