Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 2;15(1):23347.
doi: 10.1038/s41598-025-07114-2.

Natural history and prognostic nomogram of untreated triple negative breast cancer based on SEER database

Dasong Wang  1 , Yan Yang  1 , Wei Rong  1 , Li Fan  1 , Lei Yang  1 , Maoshan Chen  1 , Hongwei Yang  1 , Yu He  2
Affiliations

Natural history and prognostic nomogram of untreated triple negative breast cancer based on SEER database

Dasong Wang et al. Sci Rep. .

Abstract

Triple-negative breast cancer (TNBC) is an aggressive subtype with a relatively poor prognosis, and its natural history without therapeutic intervention remains understudied. The purpose of this study was to investigate the natural history of untreated TNBC and construct a prognostic model utilizing data from the SEER database. Data from patients diagnosed with TNBC between 2010 and 2021 were analyzed. Median survival times for each tumor stage were calculated to estimate disease progression time (defined as the difference in median survival between consecutive stages). Cox regression was employed to identify independent prognostic factors in a training set, and a prognostic nomogram was developed based on these factors. Results showed that median survival times for untreated TNBC were 65 months (stage I), 28 months (stage II), 11 months (stage III), and 3 months (stage IV), with estimated progression times from stage I to II, II to III, and III to IV being 37 months, 17 months, and 8 months, respectively. Age, multifocal breast cancer, T stage, M stage, liver metastasis, and brain metastasis were identified as independent risk factors. The nomogram demonstrated excellent predictive performance, with a C-index of 0.795 in the training set and 0.759 in the validation set, supported by favorable calibration plots and decision curve analysis (DCA). In conclusion, untreated TNBC exhibited accelerated progression and deteriorating prognosis with increasing tumor stage, with age and tumor burden serving as key prognostic indicators, and the constructed nomogram provided a reliable tool for predicting survival in untreated TNBC patients.

Keywords: Natural history; Nomogram; Surveillance Epidemiology End results (SEER); Triple negative breast cancer.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval: This study protocol was approved by the Ethics Committee of Suining Central Hospital. All information from the SEER program is available and free for public, and all patient data are deidentified, so informed consent is not required.

Figures

Fig. 1
Fig. 1
Flow chart detailing the selection of the patients in this study.
Fig. 2
Fig. 2
Survival curves for breast cancer patients in treated and untreated groups. (A) overall survival before PSM, (B) overall survival after PSM, C: cancer specific survival before PSM, D: cancer specific survival after PSM.
Fig. 3
Fig. 3
Survival curve for untreated TNBC patients at different stages. (A) Overall survival, (B) cancer specific survival.
Fig. 4
Fig. 4
Median survival time and estimated disease progression time of TNBC in different stages.
Fig. 5
Fig. 5
Nomogram predicting the 1-, 5- and 10-year overall survival of untreated group of patients with TNBC.
Fig. 6
Fig. 6
ROC curves of the nomogram for predicting overall survival in training (A) and validation (B) sets.
Fig. 7
Fig. 7
Calibration plots of the nomogram for predicting overall survival in training (A, 1-year; C, 5-year; E 10-year) and validation (B, 1-year; D, 5-year; F 10-year) sets.
Fig. 8
Fig. 8
Decision curve analysis for the Nomogram and AJCC TNM stage system in prediction of overall survival in training (A, 1-year; C, 5-year; E 10-year) and validation (B, 1-year; D, 5-year; F 10-year) sets.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Siegel, R. L., Giaquinto, A. N. & Jemal, A. Cancer statistics, 2024. CA Cancer J. Clin.74(1), 12–49 (2024). - PubMed
    1. Sung, H. et al. Global cancer statistics 2020: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin.71(3), 209–249 (2021). - PubMed
    1. Houghton, S. C. & Hankinson, S. E. Cancer progress and priorities: Breast cancer. Cancer Epidemiol. Biomark. Prev.30(5), 822–844 (2021). - PMC - PubMed
    1. Pareja, F. et al. Triple-negative breast cancer: The importance of molecular and histologic subtyping, and recognition of low-grade variants. NPJ Breast Cancer2, 16036 (2016). - PMC - PubMed
    1. Xie, N. et al. Clinicopathological characteristics and treatment strategies of triple-negative breast cancer patients with a survival longer than 5 years. Front. Oncol.10, 617593 (2020). - PMC - PubMed

LinkOut - more resources