Impact of triple negative phenotype on prognosis of breast cancer patients from a reference cancer unity in the central of Brazil

Abstract

Introduction: Triple-negative breast cancers are tumors that don’t express estrogen receptors, progesterone receptors and HER2. The triple-negative phenotype exhibits more aggressive characteristics, including early onset, high stage on diagnosis, elevated nuclear grade, high mytotic index, agressive patterns of regional and distant metastasis, besides poor prognosis. Objective: To compare the clinical and pathological aspects of a group with 345 breast cancer patients treated in a referral hospital in the center of Brazil, in order to compare the impact of triple-negative phenotype on the patient prognosis. Methods: Patients were selected in the Pathology Laboratory of the institution. Clinical and pathological data were collected from the respective clinical files. Statistical methods comprised univariate analysis and survival curves were generated by using Kaplan-Meier and Log-rank tests. Results: Classic prognostic factors were confirmed for the whole group, including regional lymph nodes metastasis (p<0.001), distant metastasis (p<0.001) and tumor size (p<0.001). By comparing the two groups of breast tumors (TN and NTN), significant statistical differences were observed concerning nuclear grade (p<0.0001) and five year survival (p<0.0001), which varied from 70.3% for NTN patients to 47.1% for TN patients. Conclusion: Our results reinforce the aggressive profile of triple-negative breast cancer that, despite of the classic prognostic factors described for breast cancer, evolves with higher aggressiveness and elevated mortality rates, requiring special attention.