Abstract P3-10-11: Triple negative breast cancer in young Peruvian patients: 15-years' experience in a public hospital
Authors: Morante Z , De la Cruz-Ku G , Pinto J , Araujo J , Eyzaguirre E , Saavedra A , Lujan M , Enriquez D , Ramirez M , Fuentes H , Neciosup S , Gomez H 
Published: February 2018

Abstract
Background: The incidence of breast cancer (BC) is low in young women and is characterized by a high prevalence of triple-negative tumors, representing a group of high risk. In this work, we describe the clinicopathological and epidemiological features of triple-negative breast cancer (TNBC) in patients aged ≤35 years.
Methods: We reviewed information of TNBC patients diagnosed at ≤35 years old and treated at the Instituto Nacional de Enfermedades Neoplasicas (between 2000 and 2014). The Cox proportional hazard model was used to identify prognostics factors for DFS and OS.
Results: In total, of 243 out 2007 cases (12.11%) were very young TNBC patients. The median follow-up was 9 years. The median age was 32 years (range: 19-35); 14.8% had obesity. A total of 40 (16.5%) patients had a family history of breast-ovary cancer (FHBOC). Regarding to the clinical-pathological characteristics, 59.4% presented T-Stages 3/4; 65.2% had nodal involvement and 7 patients (2.9%) had bilateral BC. Most of patients were diagnosed at Clinical Stage (CS) III (50.8%). The most common histological subtype the was ductal invasive carcinoma (92.1%), followed by medullar (4.5%) and lobulillar (1.7%). A high histological grade was frequent (84.7%), while 71 cases (49%) were diagnosed with vascular permeation and 55 (48.2%) with macrometastasis in lymph nodes. The majority of patients underwent mastectomy (60.2%) compared to lumpectomy (39.8%). Locoregional relapse and distant metastasis were reported in 30.9% and 49.4% of cases, respectively. The most frequent sites of metastases were lung (14.8%) and brain (11.5%). In the multivariate analysis, only N3 stage was associated with a poor outcome in terms of (N0 vs N3, HR=7.89, 95%CI:2.76-22.56, p&lt;0.001). Variables associated with the risk of death were N stage (P&lt;0.001 for N0 vs N3), neoadjuvant chemotherapy (P&lt;0.027), adjuvant chemotherapy (P&lt;0.001), and radiotherapy (P=0.008).
Conclusions: TNBC in very young Peruvian women was characterized by advanced stage at diagnosis. In these patients, nodal involvement was the most important prognostic factor for DFS. It presents distinctive characteristics and poorer outcomes in terms of DFS and OS.
Table 1. Multivariate Cox Regression Analysis.CharacteristicsPFS OS HR95% CIp valueHR95% CIp valueN0 vs N11.820.74-4.480.191.510.88-2.590.14N0 vs N22.260.69-7.360.183.031.69-5.46&lt;0.001N0 vs N37.892.76-22.56&lt;0.0013.581.83-7.01&lt;0.001Adjuvant chemotherapynsnsns0.340.20-0.55&lt;0.001Neo-Adjuvant Chemotherapynsnsns0.590.37-0.940.027Radiotherapynsnsns0.560.37-0.860.008ns = not significant
Citation Format: Morante Z, De la Cruz-Ku G, Pinto J, Araujo J, Eyzaguirre E, Saavedra A, Lujan M, Enriquez D, Ramirez M, Fuentes H, Neciosup S, Gomez H. Triple negative breast cancer in young Peruvian patients: 15-years' experience in a public hospital [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-10-11.