Triple-negative breast cancers: Unique clinical presentations and outcomes

Julie A Y Billar, Amylou Dueck, Chee Chee H Stucky, Richard J. Gray, Nabil Wasif, Donald W Northfelt, Ann E. McCullough, Barbara A Pockaj

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background: Triple-negative (TN) breast cancers lack estrogen receptor (ER), progesterone receptor (PR), and HER2/neu amplification (HER2). Few studies have been dedicated to characterizing this subset of cancer. Materials and Methods: Retrospective review of a prospectively collected database of patients treated for invasive breast cancer at a single institution. Three tumor marker groups were compared: TN [ER-/PR-/HER2-], HER2+ [ERx/PRx/HER2+], and ER+ [ER+/PRx/HER2-]. Results: Over 8 years, 123 TN, 210 HER2+, and 728 ER+ patients were identified. On average, TN patients were younger (mean age TN 59.7, HER2+ 62.0, ER+ 64.5 years, P = 0.0001). They were referred for genetic testing more frequently (17% TN, 10% HER2+, 10% ER+, P = 0.055) and were most likely to have a BRCA mutation identified if tested (24% TN, 10% HER2+, 4% ER+, P = 0.019). TN tumors were larger (mean size 2.1 cm TN, 2.0 cm HER2+, 1.8 cm ER+, P = 0.031) and most commonly detected by breast exam (54% TN, 43% HER2+, 42% ER+, P = 0.025). Lymph node involvement was least common with TN tumors (21% TN, 37% HER2+, 32% ER+, P = 0.013), and angiolymphatic invasion was less common for TN than HER2+ (18% TN, 24% HER2+, 15% ER+, P = 0.006). TN patients had significantly higher local or regional recurrence (5.7% TN, 2.9% HER2+, 1.0% ER+, P = 0.001), and the worst 5-year overall survival, although this did not reach statistical significance (85% ± 6% TN, 94% ± 2% HER2+, 91% ± 2% ER+). Conclusions: TN breast cancers are associated with unique patient presentations, tumor characteristics, and clinical outcomes of which clinicians and investigators should be aware.

Original languageEnglish (US)
JournalAnnals of Surgical Oncology
Volume17
Issue numberSUPPL. 3
DOIs
StatePublished - Oct 2010

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Triple Negative Breast Neoplasms
Estrogen Receptors
Progesterone Receptors
Neoplasms
Genetic Testing
Tumor Biomarkers

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Triple-negative breast cancers : Unique clinical presentations and outcomes. / Billar, Julie A Y; Dueck, Amylou; Stucky, Chee Chee H; Gray, Richard J.; Wasif, Nabil; Northfelt, Donald W; McCullough, Ann E.; Pockaj, Barbara A.

In: Annals of Surgical Oncology, Vol. 17, No. SUPPL. 3, 10.2010.

Research output: Contribution to journalArticle

Billar, Julie A Y ; Dueck, Amylou ; Stucky, Chee Chee H ; Gray, Richard J. ; Wasif, Nabil ; Northfelt, Donald W ; McCullough, Ann E. ; Pockaj, Barbara A. / Triple-negative breast cancers : Unique clinical presentations and outcomes. In: Annals of Surgical Oncology. 2010 ; Vol. 17, No. SUPPL. 3.
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abstract = "Background: Triple-negative (TN) breast cancers lack estrogen receptor (ER), progesterone receptor (PR), and HER2/neu amplification (HER2). Few studies have been dedicated to characterizing this subset of cancer. Materials and Methods: Retrospective review of a prospectively collected database of patients treated for invasive breast cancer at a single institution. Three tumor marker groups were compared: TN [ER-/PR-/HER2-], HER2+ [ERx/PRx/HER2+], and ER+ [ER+/PRx/HER2-]. Results: Over 8 years, 123 TN, 210 HER2+, and 728 ER+ patients were identified. On average, TN patients were younger (mean age TN 59.7, HER2+ 62.0, ER+ 64.5 years, P = 0.0001). They were referred for genetic testing more frequently (17{\%} TN, 10{\%} HER2+, 10{\%} ER+, P = 0.055) and were most likely to have a BRCA mutation identified if tested (24{\%} TN, 10{\%} HER2+, 4{\%} ER+, P = 0.019). TN tumors were larger (mean size 2.1 cm TN, 2.0 cm HER2+, 1.8 cm ER+, P = 0.031) and most commonly detected by breast exam (54{\%} TN, 43{\%} HER2+, 42{\%} ER+, P = 0.025). Lymph node involvement was least common with TN tumors (21{\%} TN, 37{\%} HER2+, 32{\%} ER+, P = 0.013), and angiolymphatic invasion was less common for TN than HER2+ (18{\%} TN, 24{\%} HER2+, 15{\%} ER+, P = 0.006). TN patients had significantly higher local or regional recurrence (5.7{\%} TN, 2.9{\%} HER2+, 1.0{\%} ER+, P = 0.001), and the worst 5-year overall survival, although this did not reach statistical significance (85{\%} ± 6{\%} TN, 94{\%} ± 2{\%} HER2+, 91{\%} ± 2{\%} ER+). Conclusions: TN breast cancers are associated with unique patient presentations, tumor characteristics, and clinical outcomes of which clinicians and investigators should be aware.",
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T2 - Unique clinical presentations and outcomes

AU - Billar, Julie A Y

AU - Dueck, Amylou

AU - Stucky, Chee Chee H

AU - Gray, Richard J.

AU - Wasif, Nabil

AU - Northfelt, Donald W

AU - McCullough, Ann E.

AU - Pockaj, Barbara A

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N2 - Background: Triple-negative (TN) breast cancers lack estrogen receptor (ER), progesterone receptor (PR), and HER2/neu amplification (HER2). Few studies have been dedicated to characterizing this subset of cancer. Materials and Methods: Retrospective review of a prospectively collected database of patients treated for invasive breast cancer at a single institution. Three tumor marker groups were compared: TN [ER-/PR-/HER2-], HER2+ [ERx/PRx/HER2+], and ER+ [ER+/PRx/HER2-]. Results: Over 8 years, 123 TN, 210 HER2+, and 728 ER+ patients were identified. On average, TN patients were younger (mean age TN 59.7, HER2+ 62.0, ER+ 64.5 years, P = 0.0001). They were referred for genetic testing more frequently (17% TN, 10% HER2+, 10% ER+, P = 0.055) and were most likely to have a BRCA mutation identified if tested (24% TN, 10% HER2+, 4% ER+, P = 0.019). TN tumors were larger (mean size 2.1 cm TN, 2.0 cm HER2+, 1.8 cm ER+, P = 0.031) and most commonly detected by breast exam (54% TN, 43% HER2+, 42% ER+, P = 0.025). Lymph node involvement was least common with TN tumors (21% TN, 37% HER2+, 32% ER+, P = 0.013), and angiolymphatic invasion was less common for TN than HER2+ (18% TN, 24% HER2+, 15% ER+, P = 0.006). TN patients had significantly higher local or regional recurrence (5.7% TN, 2.9% HER2+, 1.0% ER+, P = 0.001), and the worst 5-year overall survival, although this did not reach statistical significance (85% ± 6% TN, 94% ± 2% HER2+, 91% ± 2% ER+). Conclusions: TN breast cancers are associated with unique patient presentations, tumor characteristics, and clinical outcomes of which clinicians and investigators should be aware.

AB - Background: Triple-negative (TN) breast cancers lack estrogen receptor (ER), progesterone receptor (PR), and HER2/neu amplification (HER2). Few studies have been dedicated to characterizing this subset of cancer. Materials and Methods: Retrospective review of a prospectively collected database of patients treated for invasive breast cancer at a single institution. Three tumor marker groups were compared: TN [ER-/PR-/HER2-], HER2+ [ERx/PRx/HER2+], and ER+ [ER+/PRx/HER2-]. Results: Over 8 years, 123 TN, 210 HER2+, and 728 ER+ patients were identified. On average, TN patients were younger (mean age TN 59.7, HER2+ 62.0, ER+ 64.5 years, P = 0.0001). They were referred for genetic testing more frequently (17% TN, 10% HER2+, 10% ER+, P = 0.055) and were most likely to have a BRCA mutation identified if tested (24% TN, 10% HER2+, 4% ER+, P = 0.019). TN tumors were larger (mean size 2.1 cm TN, 2.0 cm HER2+, 1.8 cm ER+, P = 0.031) and most commonly detected by breast exam (54% TN, 43% HER2+, 42% ER+, P = 0.025). Lymph node involvement was least common with TN tumors (21% TN, 37% HER2+, 32% ER+, P = 0.013), and angiolymphatic invasion was less common for TN than HER2+ (18% TN, 24% HER2+, 15% ER+, P = 0.006). TN patients had significantly higher local or regional recurrence (5.7% TN, 2.9% HER2+, 1.0% ER+, P = 0.001), and the worst 5-year overall survival, although this did not reach statistical significance (85% ± 6% TN, 94% ± 2% HER2+, 91% ± 2% ER+). Conclusions: TN breast cancers are associated with unique patient presentations, tumor characteristics, and clinical outcomes of which clinicians and investigators should be aware.

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