Mu Lan, Liu Yuxiang, Xiao Meng, Liu Weise, Liu Miao, Wang Xin
First Department of Breast Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, P.R. China.
Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, P.R. China.
Oncol Lett. 2017 Dec;14(6):7862-7872. doi: 10.3892/ol.2017.7251. Epub 2017 Oct 23.
The role of triple-negative breast cancer (TNBC) in breast-conserving treatment is controversial. The present study aimed at evaluating the prognosis of patients with TNBC following breast-conserving treatment (BCT) within 5 years. The present study investigated a cohort of 757 patients with early stage breast cancer, diagnosed and treated with BCT between January 2002 and March 2010 at Tianjin Medical University Cancer Institute and Hospital. The patients were divided into three groups according to receptor expression: Estrogen receptor (ER) or progesterone receptor (PR)-positive; epidermal growth factor receptor 2 (HER2)-enriched: ER and PR negative but HER2-positive; TNBC: ER, PR and HER2 receptor-negative. The primary endpoint was recurrence or mortality within 5 years after breast cancer diagnosis. Multivariable Cox analysis was used to determine the risk of locoregional relapse, distant metastases, total relapse and mortality associated with the intrinsic subtypes. Of the 757 patients with status of all receptors available, 541 (71.5%) were luminal, 66 (8.7%) were HER2-enriched and 150 (19.8%) were TNBC. Patients with TNBC were more likely to have histological grade III tumors (27.3%) compared with luminal (8.3%) and HER2-enriched (16.7%) subtypes (P<0.001). Within 5 years, locoregional recurrence rate was 2.4, 7.6 and 7.3% for luminal, HER2-enriched and TNBC, respectively (P=0.005). Mortality rate was 2.2, 9.1 and 4.7% for luminal, HER2-enriched and TNBC, respectively (P=0.007). There was no significant difference in rates of distant metastases (P=0.164) and total relapse (P=0.138). TNBC was not an independent prognostic predictor for women treated with BCT within 5 years after breast cancer diagnosis on multivariate analysis. Patients with TNBC were not at significantly increased 5-year risks of locoregional recurrence, distant metastasis, total relapse or mortality at so remain appropriate candidates for BCT.
三阴性乳腺癌（TNBC）在保乳治疗中的作用存在争议。本研究旨在评估保乳治疗（BCT）后5年内TNBC患者的预后。本研究调查了2002年1月至2010年3月在天津医科大学肿瘤研究所和医院诊断并接受BCT治疗的757例早期乳腺癌患者队列。根据受体表达情况将患者分为三组：雌激素受体（ER）或孕激素受体（PR）阳性；人表皮生长因子受体2（HER2）富集型：ER和PR阴性但HER2阳性；TNBC：ER、PR和HER2受体均阴性。主要终点是乳腺癌诊断后5年内的复发或死亡。采用多变量Cox分析确定与内在亚型相关的局部区域复发、远处转移、总复发和死亡风险。在757例所有受体状态均可用的患者中，541例（71.5%）为管腔型，66例（8.7%）为HER2富集型，150例（19.8%）为TNBC。与管腔型（8.3%）和HER2富集型（16.7%）亚型相比，TNBC患者更易发生组织学III级肿瘤（27.3%）（P<0.001）。5年内，管腔型、HER2富集型和TNBC的局部区域复发率分别为2.4%、7.6%和7.3%（P=0.005）。管腔型、HER2富集型和TNBC的死亡率分别为2.2%、9.1%和4.7%（P=0.007）。远处转移率（P=0.164）和总复发率（P=0.138）无显著差异。多变量分析显示，TNBC不是乳腺癌诊断后5年内接受BCT治疗女性的独立预后预测指标。TNBC患者5年内局部区域复发、远处转移、总复发或死亡风险未显著增加，因此仍是BCT的合适候选者。
