Prevalence, clinicopathological characteristics and short term survival of triple negative and basal like breast carcinoma in a cohort of Sri Lankan patients

H. Wijesinghe, P. Thuvarakan, G. Wijesinghe, J. Fernando, U. Senarath, M. D. Lokuhetty
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Abstract

Introduction Information on triple-negative (TNBC) and basal-like (BLBC) breast carcinoma (BCa) is limited in South-Asia. We aimed to determine the prevalence and clinicopathological characteristics of TNBC and BLBC and shortterm survival of TNBC among a cohort of BCa patients. Methodology Clinicopathological characteristics and short term survival of 211 women with BCa treated at the National Hospital of Sri Lanka from 2012-2014 were analyzed, excluding postneoadjuvant chemotherapy cases. Immunohistochemistry for hormonal and HER2 receptors and basal markers (CK5/6, CK14, EGFR, 34βE12) were performed on TNBCs. Data was analyzed using chi-squared test, logistic and Cox-regression. Results Forty-five (21.33%) were TNBC (95%, CI=15.8%-26.86%), correlating with younger age (p=0.03), premenopausal state (p=0.047), negative lymph nodes (p=0.016), lower stage (p=0.011), higher Nottingham grade (p Discussion TNBC prevalence was comparable to studies from the Indian-subcontinent, however, higher than in the West. Clinicopathological characteristics were similar. Lack of association with adverse short-term survival was possibly due to exclusion of postchemotherapy cases. Conclusion Triple negative breast carcinoma prevalence was 21.33%. Younger age, premenopausal status, low TNM stage, high tumour grade, necrosis, pushing margins, lymphoid infiltrate at tumour margin, absent DCIS and absent/mild central desmoplasia were predictive of triple negative breast carcinoma. Moderate/extensive necrosis in a tumour with this morphology was predictive of basal like breast carcinoma. Triple negative breast carcinoma was not predictive of adverse short-term survival.
斯里兰卡一组患者中三阴性和基底样乳腺癌的患病率、临床病理特征和短期生存率
南亚地区关于三阴性(TNBC)和基底样(BLBC)乳腺癌(BCa)的信息有限。我们的目的是确定一组BCa患者中TNBC和BLBC的患病率和临床病理特征以及TNBC的短期生存率。方法分析2012-2014年在斯里兰卡国立医院接受BCa治疗的211例女性患者的临床病理特征和短期生存,不包括新辅助化疗后的病例。对tnbc进行激素和HER2受体及基础标志物(CK5/6、CK14、EGFR、34βE12)的免疫组化检测。数据分析采用卡方检验、logistic和cox回归。结果TNBC 45例(21.33%)(95%,CI=15.8% ~ 26.86%),与年龄较小(p=0.03)、绝经前状态(p=0.047)、淋巴结阴性(p=0.016)、分期较低(p=0.011)、诺丁汉分级较高(p)相关。临床病理特征相似。缺乏与不良短期生存的关联可能是由于排除了化疗后的病例。结论三阴性乳腺癌患病率为21.33%。年轻、绝经前状态、低TNM分期、高肿瘤分级、坏死、挤压边缘、肿瘤边缘淋巴浸润、无DCIS和无/轻度中枢性结缔组织增生是三阴性乳腺癌的预测因素。这种形态肿瘤的中度/广泛坏死预示基底样乳腺癌。三阴性乳腺癌不能预测不良的短期生存。
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