Biological Characteristics and Long-term Outcomes in Node-negative Breast Cancer

• Published in: Clinical breast cancer 2020-08, Vol.20 (4), p.e481-e489
• Main Authors: Agostinetto, Elisa, Giordano, Laura, Torrisi, Rosalba, De Sanctis, Rita, Masci, Giovanna, Losurdo, Agnese, Zuradelli, Monica, Tinterri, Corrado, Gatzemeier, Wolfgang, Testori, Alberto, Alloisio, Marco, De Rose, Fiorenza, Fernandes, Bethania, Santoro, Armando
• Format: Article
• Language: English
• Subjects: Breast cancer; Node-negative; Prognosis; Recurrence risk; Relapse risk
• ISSN: 1526-8209; 1938-0666
• DOI: 10.1016/j.clbc.2020.02.011

Because the risk of relapse of node-negative breast cancer (BC) is varying, we evaluated the prognosis of patients with this disease and the factors associated with increased risk of relapse. The clinical charts of patients with BC with evidence of negative nodes and with a potential ≥ 5-year follow-up were retrospectively reviewed. We analyzed 1276 patients. Over a median follow-up of 71.6 months (range, 1-227.2 months), we observed 159 events of relapse or death. The median RFS was 170 months. The median overall survival (OS) was 192 months. At univariate analysis, older age, negative hormonal receptors, larger tumor size and higher proliferation index (Ki67) were associated with worse recurrence-free survival (RFS) and OS (P < .05); higher grading was associated with worse RFS (P = .01). At multivariate analysis for RFS, age, Ki67 and tumor size confirmed their independent prognostic role. At multivariate analysis for OS, age and positive hormonal receptors showed an independent prognostic role. We observed no differences in prognosis between human epidermal growth factor receptor 2 (HER2) positive and triple-negative (TN) BC, but TNBC showed a worse OS compared with luminal-like BC. In node-negative BC, age, hormone receptor status, tumor size and Ki67 were prognostic factors. The TNBC subtype was not associated with poorer prognosis compared with the HER2-positive subtype, but showed a worse OS compared with luminal-like BC. Because the risk of relapse of node-negative breast cancer (BC) is largely varying, we evaluated the prognosis of a cohort of 1276 patients with this disease and the factors associated with increased risk of relapse. Overall, in node-negative BC, age, hormonal receptor status, tumor size, and Ki67 were prognostic factors. The triple-negative BC subtype was not associated with a poorer prognosis compared with the human epidermal growth factor receptor 2-positive subtype, but showed a worse overall survival compared with luminal-like BC.