Triple-negative versus non-triple-negative invasive breast carcinoma

comparison of clinicopathological characteristics, therapeutic profile and outcomes  in a hospital cohort

Abstract

Introduction: Triple-negative breast carcinoma (TNBC), defined by the absence of estrogen receptor, progesterone receptor, and HER2 expression, is an aggressive molecular subtype with unfavorable prognosis. Its characterization in Brazilian institutional cohorts contributes to understanding local disease particularities. Objective: To compare clinical-pathological characteristics, therapeutic profile, and clinical outcomes between triple-negative and nontriple- negative invasive breast carcinoma patients in a hospital cohort from Central-West Brazil. Methods: Retrospective cohort study with 97 patients with confirmed invasive breast carcinoma (DCIS excluded). Triple-negative (n=15) and non-triple-negative (n=82) groups were compared for sociodemographic, tumor, molecular, therapeutic, and outcome variables. Fisher’s exact test was used for categorical and Mann-Whitney for continuous variables (significance level: 5%). Results: TNBC accounted for 15.5% of the cohort (n=15). The triple-negative group had significantly higher mean Ki-67 (54.0% vs. 15.5%; p < 0.001) and higher proportion of grade 3 tumors (40.0% vs. 9.8%; p = 0.007). Chemotherapy was performed in 93.3% of triple-negative vs. 51.2% of non-triple-negative cases (p = 0.003), predominantly neoadjuvant (93.3% vs. 22.0%; p < 0.001). No triple-negative patient received hormone therapy vs. 90.2% in the non-triple-negative group (p < 0.001). Death rates were significantly higher in the triple-negative group (26.7% vs. 2.4%; p = 0.005), as were recurrence rates (26.7% vs. 6.1%; p = 0.030). Kaplan-Meier curves demonstrated inferior overall survival in the triple-negative group (log-rank p = 6.32 × 10-4). Conclusion: Triple-negative breast carcinoma was associated with higher tumor proliferation, greater use of neoadjuvant chemotherapy, and worse clinical outcomes compared to other subtypes. These findings reinforce the need for specific diagnostic and therapeutic strategies for this subgroup in re gional clinical practice.