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0212 Triple negative breast cancer - a retrospective analysis
Friday, 13 March 2009
Friday, 13 March 2009
Epidemiology/Pathology 0210
Retrospective analysis of clinico-pathological trends of triple negative breast cancer: Experience from a tertiary care center of South India
A. Jain1 , K. Lakshmaiah1 , K. Sajeevan1 , T. Singh Sateesh1 , P. Rao1 , G. Mukherjee2 . 1 Medical Oncology, 2 Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India Goals: Triple negative breast cancer carries a poor prognosis because of disease biology and limited treatment options. Our goal was to analyze how the triple negative subset of Indian breast cancer population behaves clinically and pathologically. Methods: We analyzed the data of breast cancer patients for whom the ER, PR and HER-2 reports were available from the year 2005 to mid 2007. Total 70 patients were analyzed for various parameters like age at presentation, stage at presentation, type of surgery, pathological features, chemotherapy received and site of relapse during follow up. Patients with metastatic disease at presentation were excluded. Results: Results: Out of 70 patients 20 (28.5%) were in the age group of 30−40 years.5 (7.1%) patient were below 30 years of age with youngest patient aged 28 years. 65 (92.8%) underwent modified radical mastectomy (MRM), 30 (42.8%) were premenopausal. Histologically 67 (95.7%) had invasive ductal carcinoma, 100% tumors were Grade III and 40 (57.1%) patients presented with node positive disease. The type of chemotherapy protocols received were FAC, EC60, FEC100 and TAC. The most common protocol received was FAC 25 (35.7%), EC60 15 (21.4%), FEC100 20 (28.5%) and TAC 10 (14.2%). The type of protocol received was based on patients’ affordability. Over a period of two years total 15 (21.4%) patients developed metastasis with brain as the most common site 4 (26.6%), liver 3 (20%), pulmonary 3 (20%) and 1 (6.6%) developed pleural effusion. 2 (13.3%) had multiple site metastasis. Bone metastasis was present in 4 (26.6%) patient but only 2 (13.3%) had isolated bone metastasis. Maximum relapses were seen in patients who received FAC or EC. Total 12 (80%) patients relapsed in FAC or EC group and 3 (20%) patients relapsed in FEC100 group. None of the patients developed metastasis in TAC group. Conclusion: Like western world in India also triple negative breast cancer present at younger age group and in premenopausal women. Most of the tumors are high grade tumors with more affinity for visceral sites at the time of recurrence. Brain is the most common site of distance metastasis. Among the chemotherapy regimens they do better if treated with TAC or FEC100 regimen. Even in adjuvant setting a prospective randomized trials only for triple negative breast cancer patients are warranted.
0211
The clinical features and prognosis of triple negative breast cancer
M. Izquierdo Sanz1 , A. Alsina Maqueda1 , M. Cabero Riera1 , R. Fabregas Xaurado1 , F. Tresserra Casas2 , M. Cusido Gimferrer1 , C. Ara Perez1 , A. Ubeda Hernandez1 . 1 Gynaecology, 2 Histology, Institut Universitari Dexeus, Barcelona, Spain Goals: Compare the clinical features and prognosis of Triple Negative breast cancer with the rest of breast cancers Methods: Analyze all breast cancers studied in Breast Diseases Committee during the period 2000–2005, comparing the clinical features and prognosis of Triple Negative with the rest of breast cancers, the overall survival, local recurrence and contralateral breast cancer were analyze with Kaplan Meier curves. Results: Studied 345 breast cancers, 22 (6’4%) Triple Negative and 323 (93’6%) non Triple Negative. In Triple Negative, the Tumour size was pT0 0 (0%), pT1a 1 (7.1%), pT1b 1 (7.1%), pT1c 8 (57.1%), pT2 3 (21.4%), pT4b 1 (7.1%); and axillary lymph node was pN0 9 (64.3%), pN1 5 (35.7%), no statistically significant differences with non Triple Negative. The histological grade was in a Grade III 52.9% and 13.8% in non-triple negative,
Poster Session II. Epidemiology/Pathology
S71
the differences were statistically significant. The overall survival was statistically worse, the local recurrences and contralateral breast cancer were higher. Conclusion: Triple Negative breast cancer has a high histological grade, more metastases, more local recurrences and contralateral breast cancer and worse overall survival.
0212
Triple negative breast cancer − a retrospective analysis
Z. Shklar1 , M. Steiner2 , A. Rabkin3 , K. Sinatzky3 , R. Rubnov3 , M. Leviov3 , S. Keren3 . 1 Lin Medical Center, 2 Oncology, Carmel medical center, Haifa, 3 Oncology, Lin Medical Center, Haifa, Israel Goals: During 2000–2005, 1073 breast cancer patients were referred to our department for further treatment and follow up. 104 of them (9.7.%) had triple negative pattern (negative ER/PR and HER-2 neu receptors). Their files were reviewed in order to examine their pattern of presentation and clinical outcome. Methods: Median age 64 years (33−93). 98% had invasive duct carcinoma, 67% had grade III tumors, and 14% showed lymphovascular invasion. 10% had locally advanced disease, (T3−4 and /or N2) and 3% presented with metastatic disease. 17% of patients received neoadjuvant chemotherapy (usually Adriamycin and Taxane combination), while 48% of patients received adjuvant chemotherapy. 66% of operable patients underwent breast conserving surgery. Median follow up was 48 months (11−93). Results: 27% of patient relapsed with a median TTR of 20 months (7−57). Only 66% of patients are currently NED. Age subgroup analysis was performed and patients <70 years (30% of patients) were compared to older patients (70%). No clinical different outcome was observed. Conclusion: Triple negative breast cancer patients consist about 10% of our breast cancer patients population. When compared with the general breast cancer population it seems that their pattern of clinical presentation is similar but their disease has more aggressive features. In spite of the small sample size it seems that time to relapse is short and their outcome is poor. Age does not seem to have an influence.
0213
Clinical characteristics of triple negative breast cancers
M. Hur1 , C. Yoon1 , S. Ko1 , H. Lee1 , S. Kim2 , H. Park3 , A. Han4 , S. Kang1 . 1 Surgery, Kwandong University College of Medicine, Cheil General Hospital, 2 Surgery, College of Medicine, Soonchunhyang University, 3 Surgery, Gachon University College of Medical and Science, 4 Surgery, Yonsei University, Wonju Medical School, Seoul, South Korea Goals: Breast cancer represents a heterogeneous group of tumors that are diverse in behaviour, outcome, and response to therapy. To reduce mortality from breast cancer, there is a desire to examine and characterize tumors of poor prognosis, to predict their biology, to ensure adequate therapy. In this study, we investigate the clinical characteristics of triple negative breast cancer (ER, PR, c-erbB2 negative, immunohistochemically: TN tumors) that lacks the benefit of targeted therapy. Methods: From January 1995 to December 2002, 1,325 invasive breast cancer patients were operated. We investigated them retrospectively, who had the median follow-up for 62 months. We examined the differences between triple negative breast cancer compared with Non-triple negative breast cancers in relation to the clinicopathological parameters, overall survival (OS), disease free survival (DFS). Statistical analysis was performed using SPSS (Chi-square, logistic regression, Kaplan–Meier). Results: 213 (16.1%) cases among 1,325 patients were triple negative breast cancers. There were positive associations with younger age (below 35 years), poorly differentiated nuclear grade, negative axillary lymph nodes in TN tumors. Tumor size, histologic classifications, lymphovascular invasion were not significantly different between TN tumors and the other group. 199 patients (93.4%) were treated with chemotherapy. 26 cases (12.2%) of TN tumor experienced locoregional or systemic metastases, and 20 cases (9.4%) died. There was no significant difference of 5 year OS and DFS between TN tumors and the other group. Conclusion: Triple negative breast cancers are associated with poorly differentiated nuclear grade and affect younger than Non-triple negative tumors. For the targeted therapy against triple negative tumor, we need to study the specific marker of these cases.
Friday, 13 March 2009
Epidemiology/Pathology 0210
Retrospective analysis of clinico-pathological trends of triple negative breast cancer: Experience from a tertiary care center of South India
A. Jain1 , K. Lakshmaiah1 , K. Sajeevan1 , T. Singh Sateesh1 , P. Rao1 , G. Mukherjee2 . 1 Medical Oncology, 2 Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India Goals: Triple negative breast cancer carries a poor prognosis because of disease biology and limited treatment options. Our goal was to analyze how the triple negative subset of Indian breast cancer population behaves clinically and pathologically. Methods: We analyzed the data of breast cancer patients for whom the ER, PR and HER-2 reports were available from the year 2005 to mid 2007. Total 70 patients were analyzed for various parameters like age at presentation, stage at presentation, type of surgery, pathological features, chemotherapy received and site of relapse during follow up. Patients with metastatic disease at presentation were excluded. Results: Results: Out of 70 patients 20 (28.5%) were in the age group of 30−40 years.5 (7.1%) patient were below 30 years of age with youngest patient aged 28 years. 65 (92.8%) underwent modified radical mastectomy (MRM), 30 (42.8%) were premenopausal. Histologically 67 (95.7%) had invasive ductal carcinoma, 100% tumors were Grade III and 40 (57.1%) patients presented with node positive disease. The type of chemotherapy protocols received were FAC, EC60, FEC100 and TAC. The most common protocol received was FAC 25 (35.7%), EC60 15 (21.4%), FEC100 20 (28.5%) and TAC 10 (14.2%). The type of protocol received was based on patients’ affordability. Over a period of two years total 15 (21.4%) patients developed metastasis with brain as the most common site 4 (26.6%), liver 3 (20%), pulmonary 3 (20%) and 1 (6.6%) developed pleural effusion. 2 (13.3%) had multiple site metastasis. Bone metastasis was present in 4 (26.6%) patient but only 2 (13.3%) had isolated bone metastasis. Maximum relapses were seen in patients who received FAC or EC. Total 12 (80%) patients relapsed in FAC or EC group and 3 (20%) patients relapsed in FEC100 group. None of the patients developed metastasis in TAC group. Conclusion: Like western world in India also triple negative breast cancer present at younger age group and in premenopausal women. Most of the tumors are high grade tumors with more affinity for visceral sites at the time of recurrence. Brain is the most common site of distance metastasis. Among the chemotherapy regimens they do better if treated with TAC or FEC100 regimen. Even in adjuvant setting a prospective randomized trials only for triple negative breast cancer patients are warranted.
0211
The clinical features and prognosis of triple negative breast cancer
M. Izquierdo Sanz1 , A. Alsina Maqueda1 , M. Cabero Riera1 , R. Fabregas Xaurado1 , F. Tresserra Casas2 , M. Cusido Gimferrer1 , C. Ara Perez1 , A. Ubeda Hernandez1 . 1 Gynaecology, 2 Histology, Institut Universitari Dexeus, Barcelona, Spain Goals: Compare the clinical features and prognosis of Triple Negative breast cancer with the rest of breast cancers Methods: Analyze all breast cancers studied in Breast Diseases Committee during the period 2000–2005, comparing the clinical features and prognosis of Triple Negative with the rest of breast cancers, the overall survival, local recurrence and contralateral breast cancer were analyze with Kaplan Meier curves. Results: Studied 345 breast cancers, 22 (6’4%) Triple Negative and 323 (93’6%) non Triple Negative. In Triple Negative, the Tumour size was pT0 0 (0%), pT1a 1 (7.1%), pT1b 1 (7.1%), pT1c 8 (57.1%), pT2 3 (21.4%), pT4b 1 (7.1%); and axillary lymph node was pN0 9 (64.3%), pN1 5 (35.7%), no statistically significant differences with non Triple Negative. The histological grade was in a Grade III 52.9% and 13.8% in non-triple negative,
Poster Session II. Epidemiology/Pathology
S71
the differences were statistically significant. The overall survival was statistically worse, the local recurrences and contralateral breast cancer were higher. Conclusion: Triple Negative breast cancer has a high histological grade, more metastases, more local recurrences and contralateral breast cancer and worse overall survival.
0212
Triple negative breast cancer − a retrospective analysis
Z. Shklar1 , M. Steiner2 , A. Rabkin3 , K. Sinatzky3 , R. Rubnov3 , M. Leviov3 , S. Keren3 . 1 Lin Medical Center, 2 Oncology, Carmel medical center, Haifa, 3 Oncology, Lin Medical Center, Haifa, Israel Goals: During 2000–2005, 1073 breast cancer patients were referred to our department for further treatment and follow up. 104 of them (9.7.%) had triple negative pattern (negative ER/PR and HER-2 neu receptors). Their files were reviewed in order to examine their pattern of presentation and clinical outcome. Methods: Median age 64 years (33−93). 98% had invasive duct carcinoma, 67% had grade III tumors, and 14% showed lymphovascular invasion. 10% had locally advanced disease, (T3−4 and /or N2) and 3% presented with metastatic disease. 17% of patients received neoadjuvant chemotherapy (usually Adriamycin and Taxane combination), while 48% of patients received adjuvant chemotherapy. 66% of operable patients underwent breast conserving surgery. Median follow up was 48 months (11−93). Results: 27% of patient relapsed with a median TTR of 20 months (7−57). Only 66% of patients are currently NED. Age subgroup analysis was performed and patients <70 years (30% of patients) were compared to older patients (70%). No clinical different outcome was observed. Conclusion: Triple negative breast cancer patients consist about 10% of our breast cancer patients population. When compared with the general breast cancer population it seems that their pattern of clinical presentation is similar but their disease has more aggressive features. In spite of the small sample size it seems that time to relapse is short and their outcome is poor. Age does not seem to have an influence.
0213
Clinical characteristics of triple negative breast cancers
M. Hur1 , C. Yoon1 , S. Ko1 , H. Lee1 , S. Kim2 , H. Park3 , A. Han4 , S. Kang1 . 1 Surgery, Kwandong University College of Medicine, Cheil General Hospital, 2 Surgery, College of Medicine, Soonchunhyang University, 3 Surgery, Gachon University College of Medical and Science, 4 Surgery, Yonsei University, Wonju Medical School, Seoul, South Korea Goals: Breast cancer represents a heterogeneous group of tumors that are diverse in behaviour, outcome, and response to therapy. To reduce mortality from breast cancer, there is a desire to examine and characterize tumors of poor prognosis, to predict their biology, to ensure adequate therapy. In this study, we investigate the clinical characteristics of triple negative breast cancer (ER, PR, c-erbB2 negative, immunohistochemically: TN tumors) that lacks the benefit of targeted therapy. Methods: From January 1995 to December 2002, 1,325 invasive breast cancer patients were operated. We investigated them retrospectively, who had the median follow-up for 62 months. We examined the differences between triple negative breast cancer compared with Non-triple negative breast cancers in relation to the clinicopathological parameters, overall survival (OS), disease free survival (DFS). Statistical analysis was performed using SPSS (Chi-square, logistic regression, Kaplan–Meier). Results: 213 (16.1%) cases among 1,325 patients were triple negative breast cancers. There were positive associations with younger age (below 35 years), poorly differentiated nuclear grade, negative axillary lymph nodes in TN tumors. Tumor size, histologic classifications, lymphovascular invasion were not significantly different between TN tumors and the other group. 199 patients (93.4%) were treated with chemotherapy. 26 cases (12.2%) of TN tumor experienced locoregional or systemic metastases, and 20 cases (9.4%) died. There was no significant difference of 5 year OS and DFS between TN tumors and the other group. Conclusion: Triple negative breast cancers are associated with poorly differentiated nuclear grade and affect younger than Non-triple negative tumors. For the targeted therapy against triple negative tumor, we need to study the specific marker of these cases.