Abstract P2-16-28: Younger age at diagnosis as a prognostic factor in Latin American triple negative breast cancer treated with neoadjuvant chemotherapy
Authors: Neffa Maria FernandaVicentini , Marta Guilherme Nader , Dornellas Abraao FerreiraLopes , Leal Alessandro , Testa Laura 
Published: March 2020

Background: Triple negative breast cancer (TNBC) typically affects younger women and is associated with an aggressive natural history and worse prognosis. Anthracycline and taxane-based neoadjuvant chemotherapy (NACT) is a standard treatment option for locally advanced TNBC. Althtough baseline and post-NACT clinical and pathologic data provide important prognostic information, the prognostic value of age remains controversial. We aim to evaluate the prognostic impact of age in the outcomes of Latin-American TNBC patients (pts) treated with NACT in a real world scenario.Methods: We performed a retrospective analysis of TNBC pts treated with NACT and surgery between 2011 and 2018 in an academic cancer center. Pts were divided into 2 groups: (A) those younger 40 years old (y) or less and (B) those who were older than 40y ate the time of diagnosis. Electronic records were reviewed for data on clinical and demographic characteristics, treatment and outcomes. Overall survival (OS) was calculated from the date of diagnosis to date of death or last data record and disease-free survival (DFS) was calculated from the date of diagnosis until the date of recurrence. The Kaplan-Meier method was used for survival analysis and the log-rank test to compare survival curves. Prognostic factors were evaluated using Cox regression.Results: We analyzed a cohort of 441 TNBC pts treated with anthracycline and taxane-based NACT followed by surgical resection. For the overall TNBC population, median age was 53.7 years (range: 24-84y), 70.3% had clinical T3-T4 tumor and 68.9% had positive axillary nodes. Groups A and B were comprised of 63 pts (14,3%) and 377 pts (85.5%), respectively. Mean age was 36.0 y for and 56.7 y for Groups A and B, respectively. Baseline characteristics were balanced between groups A and B, including the proportion of T3-T4 tumors (81.0 vs 68.4%, p = 0.052), and rates of clinically positive lymph nodes (76.2 vs 67.9%, p = 0.238). Complete pathological response rates were 20.6% and 30.7% (p = 0.134), for groups A and B, respectively. In the multivariate analysis, clinical T1-2 tumors (HR 0.49, 95%CI 0.28 - 0.84), clinical N0 staging (HR 0.50, 95%CI 0.29 - 0.87), and complete pathological response (HR 0.17, 95%CI 0.08 - 0.38) were associated with better prognosis, while younger age was significantly and independently associated with worse prognosis (HR 1.98, 95%CI 1.20 - 3.27).Conclusion: In Latin American patients with TNBC treated with NACT followed by surgery, the younger age at diagnosis was independently associated with worse prognosis. The inclusion of this under-represented subgroup of patients in future trials is essential to characterize their singularities allowing the development of personalized therapeutic strategies in this group of patients with poor prognosis.

Citation Format: Maria FernandaVicentini Neffa, Guilherme Nader Marta, Abraao FerreiraLopes Dornellas, Alessandro Leal, Laura Testa. Younger age at diagnosis as a prognostic factor in Latin American triple negative breast cancer treated with neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-16-28.