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. 2021 Mar;10(3):943-952.
doi: 10.21037/gs-20-762.

T1a triple negative breast cancer has the worst prognosis among all the small tumor (<1 cm) of TNBC and HER2-rich subtypes

Changjun Wang  1 , Ziyuan Chen  1   2 , Yidong Zhou  1 , Wei Huang  1 , Hanjiang Zhu  3 , Feng Mao  1 , Yan Lin  1 , Yanna Zhang  1 , Jinghong Guan  1 , Xi Cao  1 , Qiang Sun  1
Affiliations

T1a triple negative breast cancer has the worst prognosis among all the small tumor (<1 cm) of TNBC and HER2-rich subtypes

Changjun Wang et al. Gland Surg. 2021 Mar.

Abstract

Background: Triple negative breast cancer (TNBC), accounting for 15% of all breast cancer cases, was usually considered as the most aggressive subtype. The present study evaluated the prognosis of T1a TNBC and the impact of tumor size on T1 TNBC survival in large-scale population.

Methods: This retrospective study enrolled T1a/T1b/T1c TNBC and HER2+/hormone receptor (HoR)- patients diagnosed between 2010 to 2012 from the Surveillance, Epidemiology, and End Results database. The following information was extracted for further analyses: demographic variables including age at diagnosis, race, marital status, laterality, histological grade, T/N stage, American Joint Committee on Cancer (AJCC) stage, radiation therapy, survival and cause of death. Kaplan-Meier method and Cox regression were engaged for breast cancer specific survival (BCSS) and overall survival (OS) analyses.

Results: In all, the present study enrolled 6,953 TNBC and 2,648 HER2+/HoR- patients. T1a TNBC which generally omitted adjuvant chemotherapy had worse prognosis than T1a HER2+/HoR- [BCSS: hazard ratio (HR) 3.23, 95% confidence interval (CI): 1.05-9.09, P=0.03; OS: HR 2.63, 95% CI: 1.25-5.56, P=0.01] and T1b HER2+/HoR- (BCSS: HR 5.26, 95% CI: 1.61-16.7, P=0.006; OS: HR 3.03, 95% CI: 1.27-7.14, P=0.013) tumors which both were recommended by the National Comprehensive Cancer Network (NCCN) guideline to have chemotherapy. T1a TNBC also showed a trend with poorer prognosis than T1b TNBC, but did not reach statistical significance.

Conclusions: T1a TNBC had the worst prognosis among all small tumors (<1 cm) of TNBC and HER2+/HoR- subtypes, indicating the necessity of more intensive adjuvant treatment.

Keywords: T1a breast cancer; chemotherapy; survival; triple negative breast cancer (TNBC).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/gs-20-762). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Kaplan-Meier curves for TNBC patients with T1a/T1b/T1c tumors. *, statistical significance. TNBC, triple negative breast cancer; BCSS, breast cancer specific survival; OS, overall survival; HR, hazard ratio; CI, confidence interval.
Figure 2
Figure 2
Kaplan-Meier curves for TNBC and HER2+/HoR− breast cancer with T1a/T1b/T1c tumors. *, statistical significance. TNBC, triple negative breast cancer; HER2+/HoR−, human epidermal growth factor receptor-2 positive/hormone receptor negative; BCSS, breast cancer specific survival; OS, overall survival; HR, hazard ratio; CI, confidence interval.
Figure 3
Figure 3
Kaplan-Meier curves for T1a TNBC and T1b HER2+/HoR− breast cancer patients. *, statistical significance. TNBC, triple negative breast cancer; HER2+/HoR, human epidermal growth factor receptor-2 positive/hormone receptor negative; BCSS, breast cancer specific survival; OS, overall survival; HR, hazard ratio; CI, confidence interval.
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