Ibrahim S, et al. - Researchers investigated the clinical outcomes of young women with triple-negative breast cancer (TNBC), given that breast cancer in young women has serious socioeconomic impact with both treatment and survivorship issues affecting fertility, family life, and careers. Findings demonstrated poorer survival outcomes of TNBC in young women vs other subgroups. Considering neoadjuvant chemotherapy with the aims of achieving a complete pathologic response was recommended, even for early-stage disease. Based on the findings, intensive efforts for socioeconomic support for these women, especially in developing nations, are justified.

Methods

• Researchers used a structured proforma to obtain data from patients age 40 years or younger with biopsy-proven nonmetastatic TNBC who were treated between January 1, 2011 and March 31, 2014 at their institute.
• They used the Kaplan–Meier method, Χ² test, Fisher’s exact tests, and Cox proportional hazards regression model to perform survival estimates and additional association analyses.

Results

• They analyzed a total of 160 patients, with a median follow-up of 54 months (range 4 to 88 months).
• Early (T2; 46.9%) tumors that were mostly either node negative (40.6%) or N1 (35.6%) were seen in most of the patients with composite stage II (50.7%) disease.
• Neoadjuvant chemotherapy was used to treat one-third of patients (35%), and the rest received adjuvant chemotherapy both anthracyclines and taxanes were received by three-fourths of patients (75%).
• A pathologic complete response, a predictor of good prognosis, was achieved by one-fourth (24.5%) following neoadjuvant chemotherapy.
• Modified radical mastectomy was used to treat the majority of patients (71.2%), and this approach led to a low rate of breast conservation surgery (28.8%).
• Relapse was seen in 47 (29.3%) patients, with a median time of 17.5 months (range, 6 to 84 months) to relapse; relapse at distant sites (76.5%) was evident in most patients, with fewer local (10.6%) and regional (6%) relapses.
• The single most common site of distant metastasis (38.3%) was the brain; of all relapses, 12.8% were bone alone metastases.
• The 4-year overall survival and the 4-year disease-free survival was 75.2% (SE = 3.5) and 68.3% (SE = 3.7), respectively.
• In additional analyses, higher composite stage was related to markedly lower survival and attaining a pathologic complete response to neoadjuvant chemotherapy was related to a statistically significant survival advantage.