Urru SAM, et al. - In this uniquely large study of triple-negative breast cancer (TNBC) patients, researchers searched for further information on the clinical and pathological prognostic factors in TNBC. Findings further supported that, besides tumor stage at diagnosis, lymph node ratio among lymph node positive tumors was an additional significant predictor of survival and tumor recurrence, while Ki-67 appeared to be predictive of mortality, but not of recurrence.

Methods

• Researchers reviewed the pathological characteristics and clinical records of 841 TNBCs diagnosed between 1994 and 2015 in four major oncologic centers from Sardinia, Italy.
• According to various clinicopathological factors, they determined multivariate hazard ratios (HRs) for mortality and recurrence using Cox proportional hazards models.

Results

• A progression of the disease was evident in 275 (33.3%) TNBC patients and reports of 170 (20.2%) deaths were recognized after a mean follow-up of 4.3 years.
• After allowance for study center, significant independent prognostic factors for TNBC mortality included age at diagnosis, and various clinicopathological factors, all components of the TNM staging system.
• Researchers noticed that the HRs were 3.13, 9.65, and 29.0, for stage II, III and IV, respectively, vs stage I.
• Increased mortality was evident in association with necrosis and Ki-67 > 16% (HR: 1.61 and 1.99, respectively).
• A more favorable prognosis was evident for patients with tumor histotypes other than ductal invasive/lobular carcinomas (HR: 0.40 vs ductal invasive carcinoma).
• For histologic grade, tumor infiltrating lymphocytes, and lymphovascular invasion, they found no significant associations with mortality.
• Lymph node ratio seemed to be a stronger predictor of mortality than pathological lymph nodes stage among lymph node positive TNBCs (HR: 0.80 for pN3 vs pN1, and 3.05 for >0.65 vs <0.21 lymph node ratio), respectively.
• In this study, consistent results were observed for cancer recurrence, except for Ki-67 and necrosis that were not found to be significant predictors for recurrence.