In a nutshell
This paper studied the characteristics of recurrence (return of cancer) in patients with triple negative breast cancer.
Some background
Triple negative breast cancer is a subtype of breast cancer that is associated with poorer outlook or prognosis. It means that the tumor is estrogen receptor negative (absence of estrogen receptor; a protein found on cells), progesterone receptor negative (absence of progesterone receptor; a protein found on cells) and HER2 is nonamplified (absence of HER2; a protein). Patients with triple negative breast cancer have higher recurrence rates and shorter times to recurrence.
Methods & findings
The authors investigated the outcomes of patients with triple negative breast cancer. 414 patients with stage I to III triple negative breast cancer were identified. The majority of patients had some form of mastectomy (removal of the breast tissue) and received chemotherapy before or after surgery. Patient and tumour characteristics were collected. Information about recurrence was also collected.
During the follow-up time of 68.2 months, there were 112 deaths. Of those who died, 67% had experienced a recurrence.
Overall, 73.4% of patients had no recurrence of cancer while 26.6% had recurrent disease. Of these, 17.3% had only locoregional recurrence (cancer close to the original site) and 63.6% had only distant recurrence (cancer spread to another part of body). 19.1% had both locoregional and distant recurrence. Of the 98 patients who had a distant recurrence, 76.5% died.
The average time to recurrence was 18.8 months. The recurrence rate at 3 years was 18.6% and 22.6% at 5 years.
Patients with larger tumor size were more likely to experience a recurrence, as were patients with cancer in the lymph nodes. Patients with more advanced disease were more likely to have a recurrence. Patients who recurred were 1.69 times more likely to have received chemotherapy prior to surgery.
Cancer stage, increasing lymph nodes with cancer, tumour size and timing of chemotherapy and radiation therapy were factors associated with overall survival. After a recurrence occurred, breast cancer survival depended on whether the recurrence was local or distant.
The bottom line
The authors concluded that tumor size, cancer in lymph nodes and the receipt of chemotherapy prior to surgery were predictive of recurrence.
The fine print
The association between chemotherapy prior to surgery and recurrence may have been due to the fact that it is predominantly patients who initially present with larger or more aggressive tumors that receive chemotherapy before surgery.
Published By :
Annals of Surgical Oncology
Date :
Feb 21, 2014
I did chemo first, then double mastectomy last December. I had reconstruction and have now found two pea size lumps on the same side as the cancer on top of the implant…could this be something to be concerned about? They are not by the scar.
Thanks.
Medivizor cannot give you medical advice. However, if you have any changes, you should see your oncologist immediately. Best regards, Kathleen
how bad is stage1 TNBC Ki6755% ? what treatment should one opt?
2003 treated for TNBC in left breast with lumpectomy, A/C 4 rounds and T/T 4 roundsand radiation. This week I was just diagnosed with a .5 cm invasive carcinoma in my right breast.
Is that considered a new cancer or a metatastic cancer? Once triple negative will this one be as well?
I was told about the possible locations of re-occurrence – lungs, brain, liver and feet. How do I tell if it has reoccurred? How do I catch it?
Stage 3 and stage 2 tnbc, diagnosed on the 2nd of September 2016. Left side mastectomy, chemo, and radio. How high is recurrence in my situation please?