Recurrent versus non-recurrent triple negative breast cancer: An institutional study.
Authors: Akpoviroro Ogheneyoma , Sauers Nathan Kyle , Uwandu Queeneth , Ahmed Sameer , Humayun Sara , Castagne Myriam , Srinivasa Hema Malini , Mirza Wasique , Sharma Namita 
Published: June 2023

e13094

Background: Triple negative breast cancer(TNBC) is associated with(w/) worse outcomes than hormone positive cancers(CAs). We compared patients(pts) w/ TNBC recurrence at 5 years (recurrence cohort-R) against pts without(w/o)(non-recurrence cohort-N). Methods: Retrospective review. Inclusion criteria: female, 18-85, stage 1-3 TNBC, between 2010-2015. Results: The population had 219 pts. R: 36 pts(16.4%); N: 183 pts(83.6%). Most pts (95.9%) were Caucasian; Black pts: 3.2%, Asian pts: 0.5%, unknown race: 0.5%. Most pts (94.1%) were non-Hispanic; Hispanic:5.5%; unknown ethnicity:0.5%. No differences in race and ethnicity existed between (btwn) R and N. Mean age was 57.3 (standard deviation(σ) 12.8); mean BMI: 31.0 (σ 7.4); mean Charlson Comorbidity Index: 2.3 (σ 2.0); mean ECOG score: 0.3 (σ 0.6). No differences existed btwn R and N regarding the above variables. A personal hx of CA was present in 17.3% (38/219); there were no differences btwn R (19.4%) and N (16.9%), p 0.717. Genetic testing was performed in 37.8% (83/219); positive results were similar btwn R (20.0%) and N (25.0%); p 0.777. Mean tumor size was 25.2mm (σ 23.3); R had a larger mean size (34.4mm, σ 30.3) than N (23.3mm, σ 21.2), p 0.009. The most common disease stage was stage 2 (97/219, 44.3%). R had a greater proportion of stage 3 (30.6% vs 11.5%) and 2 disease (47.2% vs 43.7%) than N. There were no differences in the prevalence of histological grades (p 0.612) or subtypes (p 0.221) btwn R and N. All pts had surgery; clear margins occurred in 86.3%(189/219); margins were similar btwn R and N. Radiotherapy (RDT) was performed in 75.3% (165/219); more N pts (78.7%) received RDT than R (58.3%), p 0.01. Chemotherapy (CMT) was administered in 79.9%(175/219), and there were no differences btwn the prevalence of CMT btwn N (79.2%) and R (83.3%), p 0.575. Adjuvant CMT was received by 60.7% (133/219); there were no differences btwn N (62.3%) and R (52.8%), p 0.285. Neoadjuvant CMT was administered to 20.5% (45/219); there was a greater prevalence in R (33.3%) than in N(18.0%); p 0.038. Doxorubicin, cyclophosphamide and taxane(ACT) regimen was administered in 57.1% (125/219), while the combination of a taxane and cyclophosphamide (TC) was administered in 20.1% (44/219); there were no differences btwn R and N regarding ACT (p 0.073) or TC (p 0.069). Within 5 years of diagnosis, 31.5% were deceased. In N, 21.3% were deceased, while 83.3% were deceased in R(p<0.001). The mean time-to-mortality (TTM) from CA diagnosis was 51.1 months (σ 38.9). TTM was significantly shorter in R (37.4 months, σ 20.0) than in N (61.7 months, σ 46.2), p 0.005. Conclusions: R had more advanced (stage II and III) disease, while the N had less advanced (Stage 0 and I) disease. More N pts received RDT compared w/ R pts. Neoadjuvant CMT was more prevalent in R than N. R pts had significantly larger tumor sizes than N pts. Mortality was significantly greater in the R than N, and the TTM was almost twice as long in the N than R.