Suresh P, Batra Ullas, Doval D C
Department of Medical Oncology, Command Hospital (Southern Command), Pune, Maharashtra, India.
Indian J Med Paediatr Oncol. 2013 Apr;34(2):89-95. doi: 10.4103/0971-5851.116185.
Triple negative breast cancer (TNBC) is a recent concept and the burning topic of research today. Various studies have been reported in western literature on TNBCs or the similar group of basal like cancers, all highlighting the poor prognostic features of this molecular subtype in comparison to the other types of breast cancers. However extensive data from India is lacking. The aim of this study was to analyze the epidemiological and clinical profile of TNBcs at our institute.
Data on 171 patients of TNBCs registered at this hospital between 2005 and 2008 and followed up until December 2010 was collected and reviewed for epidemiological and clinical features.
The median age at presentation was 49 years (22-75 years). Sixty eight patients (40%) had lump in the breast of less than 1 month duration. Fourteen (8%) were nulliparous and 10 (7%) patients had crossed the age of 30 years at first full-term pregnancy, 89 (52%) were pre or peri-menopausal at presentation. Only 8 (5%) patients had a family history of breast or ovarian cancer. One hundred and six (62%) patients were stage II, 26 (15%) stage III, 21 (12%) stage I and 18 (10%) stage IV at presentation. One hundred and twenty eight patients (75%) had early breast cancer eligible for surgery at presentation, 25 (15%) were locally advanced and received neoadjuvant chemotherapy (NACT) and 18 (10%) were found to be metastatic. Modified radical mastectomy was the preferred surgical option by most patients (76%) who underwent upfront surgery in our study. The pathological overall response rates (complete and partial response) after NACT was 75% with complete response rate of 25% and there were no relapses in the complete responders. The median follow-up was 30 months (9-70 months). One hundred and twenty two patients (71%) were alive at last follow-up, 34 (22%) had relapsed, 18 (11%) had died due to progressive disease. Thirty one patients (18%) were lost to follow-up. Most of the relapses were systemic and rarely preceded by local relapses.
TNBCs are aggressive cancers with high rates of systemic relapses within the first 3 years of presentation. Longer follow-up of these patients is required for more mature data on these cancers.
三阴性乳腺癌（TNBC）是一个新近提出的概念，也是当今研究的热点话题。西方文献中已有多项关于TNBC或类似基底样癌组别的研究报道，所有这些研究都强调了该分子亚型与其他类型乳腺癌相比预后较差的特征。然而，印度缺乏广泛的数据。本研究的目的是分析我院TNBC的流行病学和临床特征。
收集并回顾了2005年至2008年在本院登记的171例TNBC患者的数据，并随访至2010年12月，以了解其流行病学和临床特征。
就诊时的中位年龄为49岁（22 - 75岁）。68例（40%）患者乳房肿块持续时间不到1个月。14例（8%）未生育，10例（7%）患者首次足月妊娠时年龄超过30岁，89例（52%）就诊时处于绝经前或围绝经期。仅有8例（5%）患者有乳腺癌或卵巢癌家族史。就诊时，106例（62%）患者为II期，26例（15%）为III期，21例（12%）为I期，18例（10%）为IV期。128例（75%）患者就诊时患有适合手术的早期乳腺癌，25例（15%）为局部晚期并接受了新辅助化疗（NACT），18例（10%）已发生转移。在我们的研究中，大多数接受 upfront 手术的患者（76%）选择改良根治术作为首选手术方式。NACT后的病理总缓解率（完全缓解和部分缓解）为75%，完全缓解率为25%，完全缓解者无复发。中位随访时间为30个月（9 - 70个月）。最后一次随访时，122例（71%）患者存活，34例（22%）复发，18例（11%）因疾病进展死亡。31例（18%）患者失访。大多数复发为全身性，很少先有局部复发。
TNBC是侵袭性癌症，在就诊后的前3年内全身复发率较高。需要对这些患者进行更长时间的随访以获得关于这些癌症更成熟的数据。
