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Cancer recurrence and survival in patients with early-stage triple-negative breast cancer

Background: Triple-negative breast cancer (TNBC) has fewer treatment options and is associated with a poor prognosis in the metastatic and adjuvant setting.

Objective: To evaluate the impact of triple-negative (TN) status on disease recurrence and survival among stage I-III patients who were treated with adjuvant chemotherapy in a community-based clinical practice setting.

Methods: Data were extracted from the 2003-2008 Georgia Cancer Specialist Database. Stage I-III breast cancer patients who received adjuvant chemotherapy were followed from initial diagnosis until death, recurrence, or loss to follow-up. The influence of TN status on disease-free survival (DFS) and recurrence was assessed.

Results: The study included 1,572 patients, of whom 26.3% had TNBC. The 5-year DFS was 76.8% for TNBC patients and 89.0% for non-TNBC patients (P less than .001); 5-year recurrence rates were 18.8% for TNBC and 11.2% for non-TNBC (P less than  .001). The adjusted likelihood for DFS was lower for TNBC patients (hazard ratio [HR], 0.37; P less than .001), and risk for recurrence was higher (HR, 2.85; P less than .001) compared with non-TNBC patients. In the subpopulation with confirmed race, the comparable adjusted HRs were 0.27 and 4.70 (P less than .001, for both), respectively. African American race was an independent risk factor for worse outcome.

Limitations: Some potential confounding factors are not accounted for in this study, including accessibility to health care, differences in chemotherapy type, dose intensity, and socioeconomic status.

Conclusions: Patients with stage I-III TNBC had shorter DFS and higher recurrence risk, despite having received chemotherapy. The results emphasize the need for more effective treatments.

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