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Prognostic factors in early-stage triple-negative breast cancer: lessons and limits from clinical practice.

AIM
Triple-negative breast cancer has a poor prognosis due to its aggressive behaviour and lack of effective targeted therapies. We aimed to verify whether clinical and/or pathological features may help us identify triple-negative breast cancer with a different outcome.


PATIENTS AND METHODS
Patients diagnosed with stage I-III triple-negative breast cancer at our Institution were included in the analysis. The impact of various factors (age, menopausal status, tumor characteristics, adjuvant treatment, etc.) on survival was evaluated. Univariate and multivariate analyses were performed.


RESULTS
A total of 149 patients were included in this retrospective analysis. At univariate analysis, a better disease-free survival was related to smaller tumour size and absence of lymphovascular involvement or necrosis. At multivariate analysis, tumour size and lympho-vascular invasion were independent prognostic factors.


CONCLUSION
Triple-negative breast cancer represents a heterogeneous disease with different biology and clinical behaviour. These results re-inforce the wide use of adjuvant chemotherapy for all types of triple-negative breast cancer, regardless of tumour size or lymphovascular invasion. New biomarkers are mandatory for a better stratification of this heterogeneous population.