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. 2020 Sep 25:14:1178223420962488.
doi: 10.1177/1178223420962488. eCollection 2020.

Sociodemographic, Clinical, and Pathological Factors Influencing Outcomes in Locally Advanced Triple Negative Breast Cancer: A Brazilian Cohort

Jesse Lopes da Silva  1 , Bruno Henrique Rala de Paula  1 , Isabele Avila Small  1 , Luiz Claudio Santos Thuler  1 , Andréia Cristina de Melo  1
Affiliations

Sociodemographic, Clinical, and Pathological Factors Influencing Outcomes in Locally Advanced Triple Negative Breast Cancer: A Brazilian Cohort

Jesse Lopes da Silva et al. Breast Cancer (Auckl). .

Abstract

Objective: To evaluate the association of sociodemographic, clinical, and pathological factors with response and survival in triple negative breast cancer (TNBC) undergoing neoadjuvant chemotherapy (NACT).

Methods: Clinical-pathological and sociodemographic data were obtained from medical records of 235 eligible women with TNBC diagnosed between 2010 and 2014 undergoing NACT and surgery at the Brazilian National Cancer Institute. They have been assessed for pathological complete response (pCR), event-free survival (EFS), and overall survival (OS). Both univariate and multivariate Cox regression analyses were performed.

Results: The median follow-up was 64.3 months. Most patients had advanced clinical stage (III: 85.1%; cT3/T4: 86.4%; cN1-3: 74.4%) and high-grade tumors (72.1%). Clinical staging (III vs II, adjusted hazard ratio [HR] = 2.95, P = .012) significantly influenced the pCR rate. Alcohol intake negatively influenced EFS (adjusted HR = 1.67, P = .006) and OS (adjusted HR = 1.89, P = .005). Women with pCR showed better EFS (crude HR = 0.15, P < .001) and OS (crude HR = 0.12, P < .001) compared with non-pCR. The ypT (<0.001) and ypN (<0.001) gradually influenced survival outcomes.

Conclusion: Clinical stage III were associated with lower response rate and worse survival. Alcohol intake, pCR, and burden of post-NACT residual disease have shown considerable influence on survival outcomes.

Keywords: Triple negative breast cancer; complete pathological response; neoadjuvant chemotherapy; predictive factors; prognostic factors.

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Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study profile. HER-2 indicates human epidermal growth factor receptor 2; INCA, Brazilian National Cancer Institute; NACT, neoadjuvant chemotherapy; TNBC, triple negative breast cancer.
Figure 2.
Figure 2.
Kaplan-Meier event-free survival estimates according to (A) alcohol consumption, (B) pathological tumor stage, (C) pathological nodal stage, and (D) pathological complete response. pCR indicates pathological complete response.
Figure 3.
Figure 3.
Kaplan-Meier overall survival estimates according to (A) alcohol consumption, (B) pathological tumor stage, (C) pathological nodal stage, and (D) pathological complete response. pCR indicates pathological complete response.
See this image and copyright information in PMC

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