Akademik Veri Yönetim Sistemi
15. ULUSAL MEME HASTALIKLARI KONGRESİ, Antalya, Türkiye, 17 - 20 Ekim 2019, ss.9-10
SS39-Analysis of Prognostic Factors in Patients with Tripple Negative Breast Cancer after Adjuvant
Radiotherapy after Breast Surgery: 20-Year Follow-Up Results
İlknur Bilkay Görken1
, Zümre Arıcan Alıcıkuş1
, Volkan Semiz1
, Barbaros Aydın1
, Merih Güray Durak2
, Ali İbrahim
Sevinç3
1
Department of Radiation Oncology, Dokuz Eylül University School of Medicine, İzmir, Turkey
2
Department of Pathology, Dokuz Eylül University School of Medicine, İzmir, Turkey
3
Department of General Surgery, Dokuz Eylül University School of Medicine, İzmir, Turkey
Objective: In this study, long-term follow-up results and prognostic determinants of tripple negative breast cancer patients treated with adjuvant
radiotherapy (RT) according to the protocol of Dokuz Eylul Breast Tumors Group were evaluated retrospectively.
Materials and Methods: Between January 1992 and December 2005, 215 tripple negative breast cancer patients were included in the study.
Ninety-nine (46%) patients underwent breast conserving surgery (BCS), and 115 (53.5%) patients underwent modified radical mastectomy
(MRM). Five patients (2.3%) underwent sentinal lymph node biopsy and 208 patients (96.7%) underwent axillary dissection. 50 Gy or more
radiotherapy was applied to peripheral lymphatics together with chest wall or breast in 53 patients (75.4%), and to chest wall or breast in 53
(24.6%) patients. One hundred and thirty-two (61.4%) patients received an additional dose of 10-16 Gy. One hundred and seventy-three
patiants (80.5%) received adjuvant or 15 (7%) received neoadjuvant chemotherapy (CT) (6 cycles of CAF - CEF, 4 cycles of AC or CMF or
equivalent). The staging was done according to AJCC-2018, and the survival analyzed by Kaplan-Meier and the variables were analyzed by LogRank and Cox regression analysis.
Results: Patients were aged between 25-75 years and median age was 47 years. The median follow-up was 142 months. 119 (55.3%) of the
patients were premenopausal. Histologically, 131 patients (60.9%) had invasive ductal carcinoma (IDC), 21 patients (9.8%) had invasive
lobular carcinoma (ILC), 11 patients (5.1%) had both ILK and IDC, and 52 (24.2%) had other histopathologic types. Pathologic T stages of
the patients were 4 (1.9%) pT1a, 5 (2.3%) pT1b, 52 (24.2%) pT1c, 124 (57.7%) pT2, 18 (8.4%) pT3, 7 (3.3%) pT4b, 5 (2.3%) as pT4d;
N stages were staged as 82 (38.1%) pN0, 65 (30.2%) pN1, 45 (20.9%) pN2, 23 (10.7%) pN3. Distribution of patients according to stages
were; stage 1; 38 patients (17.6%), stage 2; 103 patients (47.9%), stage 3; 74 patients (33.5%). Pericapsular invasion (PCI) was positive in 69
(32.1%) patients. Skin invasion was present in 13 (6%) patients and surgical margin was positive in 11 (5.1%) patients. While 67 (31.2%)
of the patients had distant recurrence during follow-up, 11 (5.1%) had local recurrence. 5, 10, 15 and 20-year overall (OS) and disease-free
survival (DFS) rates, respectively; 77.5%, 64.1%, 57.2%, 49.7% and 72.5%, 66.2%, 64.8%, 61.9%. In univariate analyzes, menopause status, surgery type, PCI, pT3-4 disease, pN, stage, CT scheme, distant invasion, and skin invasion were significant factors affecting prognosis S9
Eur J Breast Health 2019; Supplement(1): S1-S39
on both OS and DFS, while local spread and pT were significant for DFS. In multivariate analyzes, stage is a significant prognostic factor
for OS and DFS.
Conclusion: In tripple negative breast cancer patients, stage has a significant effect on survival regardless of molecular subtype at long follow-up.
Disease-free survival of our patients during median 10-year follow-up is quite good