Locoregional recurrence of triple-negative breast cancer after breast-conserving surgery and radiation

Cancer. 2009 Mar 1;115(5):946-51. doi: 10.1002/cncr.24094.

Abstract

Background: The results of radiation on the local control of triple receptor-negative breast cancer (negative estrogen [ER], progesterone [PR], and HER-2/neu receptors) was studied.

Methods: Conservative surgery and radiation were used in 753 patients with T1-T2 breast cancer. Three groups were defined by receptor status: Group 1: ER or PR (+); Group 2: ER and PR (-) but HER-2 (+); and Group 3: triple-negative (TN). Factors analyzed were age, menopausal status, race, stage, tumor size, lymph node status, presentation, grade, extensive in situ disease, margins, and systemic therapy. The primary endpoint was 5-year locoregional recurrence (LRR) isolated or total with distant metastases.

Results: ER- and PR-negative patients were statistically significantly more likely to be black, have T2 disease, have tumors detectable on both mammography and physical examination, have grade 3 tumors, and receive chemotherapy. There were no significant differences noted with regard to ER- and PR- patients by HER-2 status. There was a significant difference noted in rates of first distant metastases (3%, 12%, and 7% for Groups 1, 2, and 3, respectively; P = .009). However, the isolated 5-year LRR was not significantly different (2.3%, 4.6%, and 3.2%, respectively; P = .36) between the 3 groups.

Conclusions: Patients with TN breast cancer do not appear to be at a significantly increased risk for isolated LRR at 5 years and therefore remain appropriate candidates for breast conservation.

MeSH terms

  • Breast Neoplasms / pathology*
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Combined Modality Therapy
  • Female
  • Humans
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Neoplasms, Hormone-Dependent / pathology
  • Progesterone / metabolism
  • Receptor, ErbB-2 / metabolism
  • Receptors, Estrogen / metabolism

Substances

  • Receptors, Estrogen
  • Progesterone
  • ERBB2 protein, human
  • Receptor, ErbB-2