Triple negative breast cancers (TNBC) are characterised by early recurrence and poor survival. However, some women with TNBC have a more favourable outcome and long-term recurrence rates are even lower than those seen with hormone responsive tumours. In this study, we evaluated factors that predicted for distant recurrence and mortality in women with TNBC.
Materials and Methods:
Retrospective review was performed of 345 patients diagnosed with TNBC at two institutes from 1st January 2006 to 31st December 2011. Detailed analyses focused on the 315 women with non-metastatic disease. Correlation analyses were performed to evaluate the association of standard clinicopathological parameters with distant recurrence and survival.
TNBC accounted for 11.3% of all cancers diagnosed, was most prevalent among Indian women and least frequent among Chinese women. Mortality was strongly associated with distant recurrence (P <0.01) and was more common in women presenting with advanced disease (P <0.01). Nodal disease burden predicted for local recurrence (P <0.01), and local recurrence, together with ethnicity (P = 0.04), in turn predicted for distant recurrence. Chinese women were significantly less likely to develop distant recurrence (P = 0.02) and had better 5-year distant disease-free survival compared to Malay and Indian women (P = 0.04). Local recurrence and death were also less common in Chinese women, though not reaching statistically significance (P = 0.09, P = 0.40 respectively). Chinese women tended to be older at the time of diagnosis, but otherwise, tumour characteristics, stage at presentation and the treatments received were similar between Chinese, Malay and Indian women.
Ethnicity and local recurrence independently predicted for distant recurrence in women with TNBC. Chinese women had better outcomes compared to Malay and Indian women.