Kim Ja Young, Chang Sei-Kyung, Park Heily, Lee Bo-Mi, Shin Hyun Soo
Department of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Radiat Oncol J. 2012 Sep;30(3):124-31. doi: 10.3857/roj.2012.30.3.124. Epub 2012 Sep 30.
To determine whether triple negative (TN) early stage breast cancers have poorer survival rates compared with other molecular types.
Between August 2000 and July 2006, patients diagnosed with stage I, II early stage breast cancers, in whom all three markers (estrogen receptor, progesterone receptor, and human epidermal growth factor receptor [HER]-2) were available and treated with modified radical mastectomy or breast conserving surgery followed by radiotherapy, were retrospectively reviewed.
Of 446 patients, 94 (21.1%) were classified as TN, 57 (12.8%) as HER-2 type, and 295 (66.1%) as luminal. TN was more frequently associated with young patients younger than 35 years old (p = 0.002), higher histologic grade (p < 0.0001), and nuclear (p < 0.0001). The median follow-up period was 78 months (range, 4 to 130 months). There were 9 local relapses (2.0%), 15 nodal (3.4%), 40 distant metastases (9.0%), and 33 deaths (7.4%) for all patients. The rates of 5-year OS, DFS, LFS, and DMFS for all patients were 95.5%, 89.9%, 95.4%, and 91.7%, respectively. There were no significant differences in OS, DFS, LFS, and DMFS between triple negative and other subtypes (p > 0.05).
We found that patients with TN early stage breast cancers had no difference in survival rates compared with other molecular subtypes. Prospective study in homogeneous treatment group will need for a prognosis of TN early stage breast cancer.
确定三阴性（TN）早期乳腺癌与其他分子类型相比是否具有更低的生存率。
回顾性分析2000年8月至2006年7月期间诊断为Ⅰ期、Ⅱ期早期乳腺癌且三种标志物（雌激素受体、孕激素受体和人表皮生长因子受体[HER]-2）均可用，并接受改良根治性乳房切除术或保乳手术加放疗的患者。
446例患者中，94例（21.1%）被分类为TN型，57例（12.8%）为HER-2型，295例（66.1%）为管腔型。TN型更常与年龄小于35岁的年轻患者相关（p = 0.002），组织学分级更高（p < 0.0001），核分级更高（p < 0.0001）。中位随访期为78个月（范围4至130个月）。所有患者中有9例局部复发（2.0%），15例区域淋巴结转移（3.4%），40例远处转移（9.0%），33例死亡（7.4%）。所有患者的5年总生存率（OS）、无病生存率（DFS）、局部无复发生存率（LFS）和远处无转移生存率（DMFS）分别为95.5%、89.9%、95.4%和91.7%。三阴性与其他亚型之间的OS、DFS、LFS和DMFS无显著差异（p > 0.05）。
我们发现TN早期乳腺癌患者与其他分子亚型的生存率无差异。需要对同质治疗组进行前瞻性研究以评估TN早期乳腺癌的预后。
