Constructing a Clinicopathologic Prognostic Model for Triple-Negative Breast Cancer.

The objective of this study was to define a set of clinicopathologic features and survival outcomes associated with a triple-negative breast cancer (TNBC) population. We performed a retrospective analysis using the UTSW TNBC registry. The clinical and pathological data of 216 stage I to III patients with TNBC who were treated from 1998 to 2013 were collected. Univariate analysis (UVA) and multivariable (MVA) logistic regression models were constructed to identify prognostic factors associated with disease-free survival (DFS), overall survival (OS), and locoregional progression-free survival (LPFS) outcomes for a TNBC population. The median follow-up was 22.9 months. The OS and DFS were 83.3% and 77.3% at 60 months follow-up, respectively. On UVA, African American (AA) race (P = .04), clinical stage (P = .026), the presence of LVI (P < .001) were significant for worse OS. Clinical stage (P = .01), presence of LVI (P = .001), and lack of preoperative MRI (P = .01) were significantly for worse DFS. Presence of lymphovascular invasion LVI (P <.001) and lumpectomy (P = .047) were significant for worse LPFS. AA women had significantly lower OS compared with Caucasian American (CA) women over a 5-year period, 23.4% versus 64.8%, respectively (HR, 2.192; 95% CI 1.058, 4.543, P = .04). AA women also had a significantly longer time delay from diagnosis to treatment compared with CA women (61 versus 43 days respectively, P = .005). On MVA analysis, LVI (HR, 3.137; 95% CI 1.371-7.174; P = .003) predicted for worse OS, DFS (HR, 3.069; 95% CI 1.539-6.123; P <.001), and LPFS (HR, 3.924; 95% CI 2.032- 7.579; P < .001). Advanced clinical stage (Stage 3) predicted for worse OS (HR, 4.425; 95% CI 1.404-13.950; P = 0.01) and DFS (HR, 5.432; 95% CI 1.735-17.014; P ≤.001). Preoperative MRI significantly improved DFS (HR, 0.311; 95% CI, 0.129-0.753; P = .01). Mastectomy was non-significantly associated with better LPFS (HR, 2.139; 95% CI 0.890-5.139). Radiation treatment significantly decreased Advanced clinical stage, presence of LVI, use of preoperative MRI, radiation therapy, and delay from diagnosis to treatment emerged as prognostic factors among this TNBC population. AA women had a significantly longer time delay from diagnosis to treatment and a signifi- cantly lower OS compared with CA women. Future studies should explore the important role of these factors in the management and decision making for women with TNBC. Additionally, potential barriers and discrepancies in patient access to treatment deserve further exploration. [ABSTRACT FROM AUTHOR]