Lakshmaiah K C, Das U, Suresh T M, Lokanatha D, Babu G K, Jacob L A, Babu S
Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.
Ann Med Health Sci Res. 2014 Nov;4(6):933-7. doi: 10.4103/2141-9248.144917.
Triple negative breast cancers (TNBCs) are a diverse and heterogeneous group of tumors that by definition lack estrogen and progesterone receptors and amplification of the HER-2 gene. The majority of the tumors classified as TNBCs are highly malignant, patients are usually young and only a subgroup of patients responds to conventional chemotherapy with a favorable prognosis. Various studies have been reported in western literature on TNBCs, all highlighting the poor prognosis of this subtype. 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.
This was the retrospective study carried out in Tertiary Cancer Care Center in South India. Case files of all breast cancer patients were reviewed from the hospital database registered in 1 year and TNBC patients were selected for the study. Patient's characteristic, treatment, and histological features were analyzed.
A total of 322 patients were registered during the period of 1 year and 26% (84/322) of total patients were TNBC. Median age of presentation was 44.5 years. About 94% (79/84) of patients had first full-term delivery before the age of 30 years. The most common presenting symptom was left sided breast lump. Locally advanced and early breast cancer (EBC) was 51% (43/84) and 42% (36/84), respectively. Metastatic breast cancer was seen in five patients. The highest numbers of patients were node negative disease (36.9%) [31/84], followed by N1 30.95% (26/84). Most of the patients had high-grade tumor. 94% (34/36) of cases of EBC had undergone upfront modified radical mastectomy. Invasive ductal carcinoma was the predominant histology except one who had medullary carcinoma. Twenty-four patients received neoadjuvant chemotherapy (NACT). There was no pathological complete remission, but all patients responded to NACT. Metastatic disease was seen in five patients. All patients had bone metastasis.
TNBCs are highly aggressive subtype, with high grade with limited treatment options and very poor prognosis. Incidence is more in our country than the western literature. Even in our country also the incidence is varies in different region. TNBCs are significantly associated with young aged patients. There was a lack of association between tumor size and lymph node positivity.
三阴性乳腺癌（TNBC）是一组多样且异质性的肿瘤，根据定义，其缺乏雌激素和孕激素受体，且HER-2基因无扩增。大多数被归类为TNBC的肿瘤具有高度恶性，患者通常较为年轻，只有一小部分患者对传统化疗有反应且预后良好。西方文献中已报道了多项关于TNBC的研究，均强调了该亚型预后不良。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。
这是一项在印度南部三级癌症护理中心进行的回顾性研究。从医院数据库中回顾了1年内登记的所有乳腺癌患者的病历，并选择TNBC患者进行研究。分析了患者的特征、治疗情况和组织学特征。
1年内共登记了322例患者，其中26%（84/322）为TNBC。中位发病年龄为44.5岁。约94%（79/84）的患者在30岁之前首次足月分娩。最常见的症状是左侧乳房肿块。局部晚期和早期乳腺癌（EBC）分别占51%（43/84）和42%（36/84）。5例患者出现转移性乳腺癌。患者中数量最多的是无淋巴结转移疾病（36.9%）[31/84]，其次是N1期占30.95%（26/84）。大多数患者为高级别肿瘤。94%（34/36）的EBC病例接受了 upfront改良根治性乳房切除术。除1例为髓样癌外，浸润性导管癌是主要的组织学类型。24例患者接受了新辅助化疗（NACT）。无病理完全缓解，但所有患者对NACT均有反应。5例患者出现转移性疾病。所有患者均有骨转移。
TNBC是一种高度侵袭性的亚型，级别高，治疗选择有限，预后极差。我国的发病率高于西方文献报道。即使在我国，不同地区的发病率也有所不同。TNBC与年轻患者显著相关。肿瘤大小与淋巴结阳性之间缺乏相关性。
