Impact of radiation therapy on survival in patients with triple‑negative breast cancer
- Authors:
- Lauren T. Steward
- Feng Gao
- Marie A. Taylor
- Julie A. Margenthaler
View Affiliations
Affiliations: Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA, Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA, Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Published online on: November 22, 2013 https://doi.org/10.3892/ol.2013.1700
-
Pages:
548-552
Metrics: Total
Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
This article is mentioned in:
Abstract
Triple‑negative breast cancer (TNBC) has a poorer prognosis compared with other sub-groups. In the current study, survival associated with locoregional treatment of females with TNBC was investigated. Specifically, 468 patients with stage I‑III TNBC treated between 2002 and 2009 were identified. Data included patient and tumor characteristics, treatment received and survival. Data were compared using χ2 and Fisher's exact tests, as well as MANOVA. Kaplan‑Meier curves were generated. The study cohort had a mean age of 54±13 years old with a mean follow‑up period of 51±21 months. Of 468 patients, 249 (53%) underwent lumpectomy, 63 (14%) underwent simple mastectomy (SM) and 156 (33%) underwent modified radical mastectomy (MRM). Overall, 263 (56%) received adjuvant radiation, including 178/249 (71%) following lumpectomy, 13/63 (21%) following SM and 72/156 (46%) following MRM (P<0.0001). Following control for potential confounders in univariate tests, adjuvant radiation was associated with improved overall survival in the total cohort (HR, 0.46; 95% CI, 0.31‑0.68; P=0.0001). When comparing survival by surgical type, receipt of adjuvant radiation significantly improved survival in the lumpectomy group (HR, 0.30; 95% CI, 0.16‑0.58; P=0.0004), but was not associated with improved survival in the SM group (HR, 0.38; 95% CI, 0.05‑3.04; P=0.36) or in the MRM group (HR, 0.79; 95% CI, 0.46‑1.34; P=0.38). The survival benefit of adjuvant radiation in these TNBC patients is attributed to those undergoing breast‑conserving therapy. There was no benefit in either mastectomy group. These data warrant validation from prospective trials, in order to develop tailored locoregional treatment for patients with TNBC.
View References
1
|
Zaky SS, Lund M, May KA, et al: The
negative effect of triple-negative breast cancer on outcome after
breast-conserving therapy. Ann Surg Oncol. 18:2858–2865. 2011.
View Article : Google Scholar
|
2
|
Fornier M and Fumoleau P: The paradox of
triple negative breast cancer: novel approaches to treatment.
Breast J. 18:41–51. 2012. View Article : Google Scholar : PubMed/NCBI
|
3
|
Carey LA, Perou CM, Livasy CA, et al:
Race, breast cancer subtypes, and survival in the Carolina Breast
Cancer Study. JAMA. 295:2492–2502. 2006. View Article : Google Scholar : PubMed/NCBI
|
4
|
Houssami N, Macaskill P, von Minckwitz G,
Marinovich ML and Mamounas E: Meta-analysis of the association of
breast cancer subtype and pathologic complete response to
neoadjuvant chemotherapy. Eur J Cancer. 48:3342–3354. 2012.
View Article : Google Scholar : PubMed/NCBI
|
5
|
Asaga S, Kinoshita T, Hojo T, Suzuki J,
Jimbo K and Tsuda H: Prognostic factors for triple-negative breast
cancer patients receiving preoperative systemic chemotherapy. Clin
Breast Cancer. 13:40–46. 2013. View Article : Google Scholar
|
6
|
Lowery AJ, Kell MR, Glynn RW, Kerin MJ and
Sweeney KJ: Locoregional recurrence after breast cancer surgery: a
systematicreview by receptor phenotype. Breast Cancer Res Treat.
133:831–841. 2012. View Article : Google Scholar : PubMed/NCBI
|
7
|
Billar JA, Dueck AC, Stucky CC, et al:
Triple-negative breast cancers: unique clinical presentations and
outcomes. Ann Surg Oncol. 17(Suppl 3): 384–390. 2010. View Article : Google Scholar : PubMed/NCBI
|
8
|
Dent R, Trudeau M, Pritchard KI, et al:
Triple-negative breast cancer: clinical features and patterns of
recurrence. Clin Cancer Res. 13:4429–4434. 2007. View Article : Google Scholar : PubMed/NCBI
|
9
|
Abdulkarim B, Cuartero J, Hanson J,
Deschênes J, Lesniak D and Sabri S: Increased risk of locoregional
recurrence for women with T1-2N0 triple-negative breast cancer
treated with modified radical mastectomy without adjuvant radiation
therapy compared with breast-conserving therapy. J Clin Oncol.
29:2852–2858. 2011. View Article : Google Scholar
|
10
|
Wang J, Shi M, Ling R, et al: Adjuvant
chemotherapy and radiotherapy in triple-negative breast carcinoma:
a prospective randomized controlled multi-center trial. Radiother
Oncol. 100:200–204. 2011. View Article : Google Scholar : PubMed/NCBI
|
11
|
Haffty BG, Yang Q, Reiss M, et al:
Locoregional relapse and distant metastasis in conservatively
managed triple negative early-stage breast cancer. J Clin Oncol.
24:5652–5657. 2006. View Article : Google Scholar : PubMed/NCBI
|
12
|
Panoff JE, Hurley J, Takita C, et al: Risk
of locoregional recurrence by receptor status in breast cancer
patients receiving modern systemic therapy and post-mastectomy
radiation. Breast Cancer Res Treat. 128:899–906. 2011. View Article : Google Scholar
|
13
|
Dragun AE, Pan J, Rai SN, Kruse B and Jain
DL: Locoregional recurrence in patients with triple-negative breast
cancer: preliminary results of a single institution study. Am J
Clin Oncol. 34:231–237. 2011. View Article : Google Scholar
|
14
|
Kyndi M, Sørensen FB, Knudsen H, et al;
Danish Breast Cancer Cooperative Group. Estrogen receptor,
progesterone receptor, HER-2, and response to postmastectomy
radiotherapy in high-risk breast cancer: the Danish Breast Cancer
Cooperative Group. J Clin Oncol. 26:1419–1426. 2008. View Article : Google Scholar
|