Objective: The aim of this study is to compare the clinicopathologic characteristics and disease-free survival of triple-negative breast cancer with human epidermal growth factor receptor-2-overexpressing (Her-2-overexpressing) breast cancer.
Methods: 770 breast cancer patients were surgically treated between 1998 and 2003 in Changhai Hospital, Shanghai. Patients with triple negative phenotype were identified from those using immunochemistry and CISH. The differences between triple-negative breast cancer and Her-2-overexpressing breast cancers were analyzed in p53 and E-cadherin status, age, tumor size, tumor location, histological types and grading, lymph node metastasis, AJCC stage, chemotherapy and surgical procedures,as well as identified prognostic factors with regards to disease-free survival.
Results: Ninety-six (12.5%) patients with triple-negative phenotype, and 164 (21.3%) with Her-2-overexpressing one were identified from the 770 breast cancer patients. No significant difference between two phenotypes in p53 and E-cadherin expression was found (P>0.05). When compared with Her-2-overexpressing breast cancer patients, triple negative breast cancer patients experienced more lymph node metastases (71.9% vs. 58.5%, P = 0.034), and had a higher percentage of more than 10 lymph nodes metastases (26.0% vs. 12.2%, P = 0.034); and showed a higher percentage of histological grade 3 (67.7% vs. 42.1%, P<0.0001). Furthermore, the tumor size was found to be related to lymph node metastasis in triple-negative breast cancer patients (P = 0.024). No significant difference between the two phenotypes in the rates of local recurrence and distant metastasis was observed (P>0.05). However, 5-year disease-free survival in patients with triple negative phenotype was significantly shorter than that in the patients with Her-2-overexpressing phenotype (61.85 mon vs. 78.69 mon, P = 0.047).
Conclusion: Compared with Her-2-overexpressing breast cancer, triple-negative breast cancer is more malignant and has a poorer disease-free survival.