Clinicopathological features and prognosis of patients with triple-negative special types of breast cancer / 肿瘤

ABSTRACT

Objective: To examine the clinicopathological features and prognosis of triple-negative special types of breast cancer (SBC). Methods: The clinical data of 240 patients with triple-negative SBC who were treated in Tianjin Medical University Cancer Institute and Hospital from January 2011 to December 2014 were collected. The clinicopathological features and survival time of patients were retrospectively analyzed. The univariate analysis of survival factors was performed by log-rank test, and the multivariate analysis of survival factors was performed by COX proportional hazard model. Results: Among the 240 patients, there were 38 cases of medullary carcinoma, 84 cases of metaplastic carcinoma, 19 cases of adenoid cystic carcinoma, 31 cases of invasive lobular carcinoma, 30 cases of apocrine carcinoma, and 38 cases of mixed lobular-ductal carcinoma. The histological grade, tumor T stage, lymph node metastasis, Ki-67 expression, chemotherapy or not and chemotherapy regimens had statistically significant differences among the different histological types of triple-negative SBC patients (all P < 0.05). The 5-year disease-free survival (DFS) and 5-year overall survival (OS) rates in patients with mixed lobular-ductal carcinoma, metaplastic carcinoma or invasive lobular carcinoma were lower than those in patients with adenoid cystic carcinoma, medullary carcinoma or apocrine carcinoma (all P < 0.01). The 5-year DFS and OS rates of patients with triple-negative SBC were correlated with histological grade, tumor T stage, lymph node metastasis, chemotherapy and histological type (all P < 0.05). Tumor T stage, lymph node metastasis, chemotherapy and histological type were independent prognostic factors on the 5-year DFS and OS in the triple-negative SBC patients (all P < 0.05). The metaplastic carcinoma patients after platinumbased chemotherapy (P = 0.044) and the mixed lobular-ductal carcinoma patients after anthracycline combined with taxane-based chemotherapy (P = 0.008) obtained longer DFS time. Conclusion: Triple-negative SBC patients with different histological types have different clinicopathological features and prognosis. The patients with adenoid cystic carcinoma, medullary carcinoma and apocrine carcinoma have a better prognosis, while the patients with metaplastic carcinoma, invasive lobular carcinoma and mixed lobular-ductal carcinoma have a poor prognosis. Platinum-based chemotherapy can be used in the treatment of patients with triple-negative metaplastic carcinoma.