Triple Negative Status is a Poor Prognostic Indicator in Chinese Women with Breast Cancer: a Ten Year Review

Abstract

<b>Background:</b> Ethnic variation in tumor characteristics and clinical presentation of breast cancer is increasinglybeing emphasized. We studied the tumor characteristics and factors which may influence the presentation andprognosis of triple negative breast cancers (TNC) in a cohort of Chinese women. <br/><b>Methods</b>: A prospective cohortof 1800 Chinese women with breast cancer was recruited in a tertiary referral unit in Hong Kong between1995 and 2006 and was followed up with a median duration of 7.2 years. Of the total, 216 (12.0%) had TNCand 1584 (88.0%) had non-TNC. Their clinicopathological variables, epidemiological variables and clinicaloutcomes were evaluated. <br/><b>Results</b>: Patients with TNC had similar age of presentation as those with non-TNC,while presenting at earlier stages (82.4% were stage 1-2, compared to 78.4% in non-TNC, p=0.035). They werelikely to be associated with grade 3 cancer (Hazard Ratio(HR)=5.8, p<0.001). TNC showed higher chance ofvisceral relapse (HR=2.69, p<0.001), liver metastasis (HR=1.7, p=0.003) and brain metastasis (HR=1.8, p=0.003).Compared with non-TNC group, TNC had similar 10-year disease-free survival (82% vs 84%, p=0.148), overallsurvival (78% vs 79%, p=0.238) and breast cancer-specific mortality (18% vs 16%, p=0.095). However, TNCshowed poorer 10-year stage 3 and 4 specific survival (stage 3: 53% vs. 67%, p=0.010; stage 4: 0% vs. 40%, p= 0.035). <br/><b>Conclusions</b>: Chinese women with triple negative breast cancer do not have less aggressive biologicalbehavior compared to the West and presentation at a later stage results in worse prognosis compared with thosewith non triple negative breast cancer.