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Üçlü Negatif Meme Kanseri Hastalarında Lokal ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi

Yıl 2022, Cilt: 48 Sayı: 3, 341 - 347, 30.12.2022
https://doi.org/10.32708/uutfd.1205387

Öz

Üçlü negatif meme kanserinde (ÜNMK) hastalık erken evrede tespit edilse de, hastalıksız sağkalım (HSK) ve sağkalım, ÜNMK olmayanlara göre daha düşüktür ve lokal nüks/ uzak metastaz daha erken ortaya çıkma eğilimindedir. Lokal ileri ÜNMK hastalarında neoadjuvan tedavi (NKT) öncelikle tercih edilmektedir. NKT ve tedaviye patolojik tam yanıt (pCR) ise HSK artırmaktadır. Bu çalışma Uludağ Üniversitesi Tıp Fakültesi Meme Cerrahi Kliniğinde ÜNMK tanısı ile ameliyat edilen hastaların lokal ve bölgesel rekürrens (LBR) oranlarına ve rekürrenssiz sağkalımına (LBRSK) etki eden faktörlerini ortaya konulması amaçlanmıştır. 2007-2020 yılları arasında ameliyat edilen hastaların demografik, klinik, patolojik verileri ve sağkalım oranları retrospektif olarak analiz edildi. İstatistiksel analizler SPSS v23 istatistik programı kullanılarak yapıldı. 173 hastanın 83’ü (%47,7) premenopozal ve yaş ortalaması 49,36+12,29 yıldı. Hastaların 106’sı (%63,8) lokal evre, 59’u (%34,1) lokal ileri evre ve 8’i (%4,6) metastatikti. 101 (%58,4) hastaya neoadjuvant, 69 (%40) hastaya adjuvant kemoterapi verildi. 122 (%70,5) hastaya meme koruyucu cerrahi, 99 (%57,2) hastaya sentinel lenf nodu örneklemesi yapıldı. Genel takip süresi ortanca değeri 57,5 ay içerisinde, 34 (%19,7) hasta yaşamını yitirdi. Ortanca rekürrens zamanı 33 ay içerisinde ise 16 (%11,8) hastada lokal nüks, 39 (%26,6) hastada sistemik nüks izlendi. 3-yıllık LBRSK oranı %47,3 izlendi. ÜNMK’de lokal ve sistemik nüks varlığında LBRSK oranları adjuvant ve neoadjuvant tedavide benzer izlenmiştir. NKT sonrası lokal ve rejyonel rekürrensi artıran ve rekürrenssiz sağkalımı azaltan en önemli faktör N3 hastalık ve premenopozal durum olarak izlenmiştir.

Kaynakça

  • 1. Yin L, Duan JJ, Bian XW, Yu SC. Triple-negative breast cancer molecular subtyping and treatment progress. Breast Cancer Res. 2020 Jun 9;22(1):61. doi: 10.1186/s13058-020-01296-5.
  • 2. Zhang L, Hao C, Dong G, Tong Z. Analysis of Clinical Features and Outcome of 356 Triple-Negative Breast Cancer Patients in China. Breast Care (Basel). 2012 Feb;7(1):13-17. doi: 10.1159/000336539.
  • 3. Tufano AM, Teplinsky E, Landry CA. Updates in Neoadjuvant Therapy for Triple Negative Breast Cancer. Clin Breast Cancer. 2021 Feb;21(1):1-9. doi: 10.1016/j.clbc.2020.07.001.
  • 4. Fayanju OM, Ren Y, Thomas SM, et al. The Clinical Significance of Breast-only and Node-only Pathologic Complete Response (pCR) After Neoadjuvant Chemotherapy (NACT): A Review of 20,000 Breast Cancer Patients in the National Cancer Data Base (NCDB). Ann Surg. 2018 Oct;268(4):591-601. doi: 10.1097/SLA.0000000000002953.
  • 5. Budakoglu B, Altundag K, Aksoy S, et al Outcome of 561 non-metastatic triple negative breast cancer patients: multi-center experience from Turkey. J BUON. 2014 Oct-Dec;19(4):872-8.
  • 6. Ugras S, Stempel M, Patil S, Morrow M. Estrogen receptor, progesterone receptor, and HER2 status predict lymphovascular invasion and lymph node involvement. Ann Surg Oncol 2014;21(12):3780–6.
  • 7. Lin NU, Vanderplas A, Hughes ME, et al. Clinicopathologic features, patterns of recurrence, and survival among women with triple-negative breast cancer in the National Comprehensive Cancer Network. Cancer 2012;118(22):5463–72.
  • 8. Chaudhary LN, Wilkinson KH, Kong A. Triple-Negative Breast Cancer: Who Should Receive Neoadjuvant Chemotherapy? Surg Oncol Clin N Am. 2018 Jan;27(1):141-153. doi: 10.1016/j.soc.2017.08.004.
  • 9. Trivers KF, Lund MJ, Porter PL, et al. The epidemiology of triple-negative breast cancer, including race. Cancer Causes Control. 2009 Sep;20(7):1071-82. doi: 10.1007/s10552-009-9331-1.
  • 10. Cao JQ, Truong PT, Olivotto IA, et al. Should women younger than 40 years of age with invasive breast cancer have a mastectomy? 15-year outcomes in a population-based cohort. Int J Radiat Oncol Biol Phys. 2014 Nov 1;90(3):509-17. doi: 10.1016/j.ijrobp.2014.06.041.
  • 11. Dent R, Trudeau M, Pritchard KI, et al. Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res. 2007 Aug 1;13(15 Pt 1):4429-34. doi: 10.1158/1078-0432.CCR-06-3045.
  • 12. Steward L, Conant L, Gao F, Margenthaler JA. Predictive factors and patterns of recurrence in patients with triple negative breast cancer. Ann Surg Oncol. 2014 Jul;21(7):2165-71. doi: 10.1245/s10434-014-3546-4.
  • 13. Gamucci T, Vaccaro A, Ciancola F, et al. Recurrence risk in small, node-negative, early breast cancer: a multicenter retrospective analysis. J Cancer Res Clin Oncol. 2013 May;139(5):853-60. doi: 10.1007/s00432-013-1388-2.
  • 14. Arvold ND, Taghian AG, Niemierko A, et al. Age, breast cancer subtype approximation, and local recurrence after breast-conserving therapy. J Clin Oncol. 2011 Oct 10;29(29):3885-91. doi: 10.1200/JCO.2011.36.1105.
  • 15. Hernandez-Aya LF, Chavez-Macgregor M, Lei X, et al. Nodal status and clinical outcomes in a large cohort of patients with triple-negative breast cancer. J Clin Oncol. 2011 Jul 1;29(19):2628-34. doi: 10.1200/JCO.2010.32.1877.
  • 16. Carey LA, Dees EC, Sawyer L, et al. The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res. 2007 Apr 15;13(8):2329-34. doi: 10.1158/1078-0432.CCR-06-1109.
  • 17. Liedtke C, Mazouni C, Hess KR, et al. Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. J Clin Oncol. 2008 Mar 10;26(8):1275-81. doi: 10.1200/JCO.2007.14.4147.
  • 18. Cortazar P, Zhang L, Untch M, et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet. 2014 Jul 12;384(9938):164-72. doi: 10.1016/S0140-6736(13)62422-8.
  • 19. Masuda H, Masuda N, Kodama Y, et al. Predictive factors for the effectiveness of neoadjuvant chemotherapy and prognosis in triple-negative breast cancer patients. Cancer Chemother Pharmacol. 2011 Apr;67(4):911-7. doi: 10.1007/s00280-010-1371-4.
  • 20. Fisher B, Bryant J, Wolmark N, et al. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998 Aug;16(8):2672-85. doi: 10.1200/JCO.1998.16.8.2672.
  • 21. Pogoda K, Niwińska A, Murawska M, Pieńkowski T. Analysis of pattern, time and risk factors influencing recurrence in triple-negative breast cancer patients. Med Oncol. 2013 Mar;30(1):388. doi: 10.1007/s12032-012-0388-4.

Factors Affecting Local and Regional Recurrence-Free Survival in Triple Negative Breast Cancer Patients: A Single Center Experience

Yıl 2022, Cilt: 48 Sayı: 3, 341 - 347, 30.12.2022
https://doi.org/10.32708/uutfd.1205387

Öz

Although the disease is detected at an early stage in patients with triple negative breast cancer (TNBC), the disease-free survival (DFS) and survival rates are lower than those without TNBC, and local recurrence or distant metastasis tends to occur earlier. Neoadjuvant therapy (NCT) is primarily preferred for patients with locally advanced TNBC. NCT and the pathological complete response (pCR) to treatment increase the DFS rate. This study aims to reveal the factors affecting local and regional recurrence-free survival (LRRFS) rate of patients operated on with the diagnosis of TNBC in the Breast Surgery Clinic of Uludağ University Faculty of Medicine. The demographic, clinical, and pathological data and survival rates of patients operated on between 2007 and 2020 were analyzed retrospectively. Statistical analyses were performed using the SPSS version 23 statistical software program. Eight-three (47.7%) of the 173 patients who participated in the study were premenopausal and the mean age of the patients was 49.36+12.29 years. One hundred six (63.8%) of the patients were at the local stage, 59 (34.1%) were at the local advanced stage and 8 (4.6%) were metastatic. Neoadjuvant chemotherapy was given to 101 (58.4%) patients and adjuvant chemotherapy was given to 69 (40%) patients. One hundred twenty-two (70.5%) patients underwent breast-sparing surgery, and 99 (57.2%) patients underwent sentinel lymph node sampling. The median value of the overall follow-up period was 57.5 months, and 34 (19.7%) patients lost their lives. In the median recurrence time of 33 months, 16 (11.8%) patients had local recurrence and 39 (26.6%) patients had systemic recurrence. The three-year LRDFS rate was observed as 47.3%. The LRDFS rates were similar after the adjuvant and neoadjuvant treatments in the presence of local and systemic recurrence of TNBC. The most important factors that increased local and regional recurrence after NCT and reduced recurrence-free survival were N3 disease and premenopausal status.

Kaynakça

  • 1. Yin L, Duan JJ, Bian XW, Yu SC. Triple-negative breast cancer molecular subtyping and treatment progress. Breast Cancer Res. 2020 Jun 9;22(1):61. doi: 10.1186/s13058-020-01296-5.
  • 2. Zhang L, Hao C, Dong G, Tong Z. Analysis of Clinical Features and Outcome of 356 Triple-Negative Breast Cancer Patients in China. Breast Care (Basel). 2012 Feb;7(1):13-17. doi: 10.1159/000336539.
  • 3. Tufano AM, Teplinsky E, Landry CA. Updates in Neoadjuvant Therapy for Triple Negative Breast Cancer. Clin Breast Cancer. 2021 Feb;21(1):1-9. doi: 10.1016/j.clbc.2020.07.001.
  • 4. Fayanju OM, Ren Y, Thomas SM, et al. The Clinical Significance of Breast-only and Node-only Pathologic Complete Response (pCR) After Neoadjuvant Chemotherapy (NACT): A Review of 20,000 Breast Cancer Patients in the National Cancer Data Base (NCDB). Ann Surg. 2018 Oct;268(4):591-601. doi: 10.1097/SLA.0000000000002953.
  • 5. Budakoglu B, Altundag K, Aksoy S, et al Outcome of 561 non-metastatic triple negative breast cancer patients: multi-center experience from Turkey. J BUON. 2014 Oct-Dec;19(4):872-8.
  • 6. Ugras S, Stempel M, Patil S, Morrow M. Estrogen receptor, progesterone receptor, and HER2 status predict lymphovascular invasion and lymph node involvement. Ann Surg Oncol 2014;21(12):3780–6.
  • 7. Lin NU, Vanderplas A, Hughes ME, et al. Clinicopathologic features, patterns of recurrence, and survival among women with triple-negative breast cancer in the National Comprehensive Cancer Network. Cancer 2012;118(22):5463–72.
  • 8. Chaudhary LN, Wilkinson KH, Kong A. Triple-Negative Breast Cancer: Who Should Receive Neoadjuvant Chemotherapy? Surg Oncol Clin N Am. 2018 Jan;27(1):141-153. doi: 10.1016/j.soc.2017.08.004.
  • 9. Trivers KF, Lund MJ, Porter PL, et al. The epidemiology of triple-negative breast cancer, including race. Cancer Causes Control. 2009 Sep;20(7):1071-82. doi: 10.1007/s10552-009-9331-1.
  • 10. Cao JQ, Truong PT, Olivotto IA, et al. Should women younger than 40 years of age with invasive breast cancer have a mastectomy? 15-year outcomes in a population-based cohort. Int J Radiat Oncol Biol Phys. 2014 Nov 1;90(3):509-17. doi: 10.1016/j.ijrobp.2014.06.041.
  • 11. Dent R, Trudeau M, Pritchard KI, et al. Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res. 2007 Aug 1;13(15 Pt 1):4429-34. doi: 10.1158/1078-0432.CCR-06-3045.
  • 12. Steward L, Conant L, Gao F, Margenthaler JA. Predictive factors and patterns of recurrence in patients with triple negative breast cancer. Ann Surg Oncol. 2014 Jul;21(7):2165-71. doi: 10.1245/s10434-014-3546-4.
  • 13. Gamucci T, Vaccaro A, Ciancola F, et al. Recurrence risk in small, node-negative, early breast cancer: a multicenter retrospective analysis. J Cancer Res Clin Oncol. 2013 May;139(5):853-60. doi: 10.1007/s00432-013-1388-2.
  • 14. Arvold ND, Taghian AG, Niemierko A, et al. Age, breast cancer subtype approximation, and local recurrence after breast-conserving therapy. J Clin Oncol. 2011 Oct 10;29(29):3885-91. doi: 10.1200/JCO.2011.36.1105.
  • 15. Hernandez-Aya LF, Chavez-Macgregor M, Lei X, et al. Nodal status and clinical outcomes in a large cohort of patients with triple-negative breast cancer. J Clin Oncol. 2011 Jul 1;29(19):2628-34. doi: 10.1200/JCO.2010.32.1877.
  • 16. Carey LA, Dees EC, Sawyer L, et al. The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res. 2007 Apr 15;13(8):2329-34. doi: 10.1158/1078-0432.CCR-06-1109.
  • 17. Liedtke C, Mazouni C, Hess KR, et al. Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. J Clin Oncol. 2008 Mar 10;26(8):1275-81. doi: 10.1200/JCO.2007.14.4147.
  • 18. Cortazar P, Zhang L, Untch M, et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet. 2014 Jul 12;384(9938):164-72. doi: 10.1016/S0140-6736(13)62422-8.
  • 19. Masuda H, Masuda N, Kodama Y, et al. Predictive factors for the effectiveness of neoadjuvant chemotherapy and prognosis in triple-negative breast cancer patients. Cancer Chemother Pharmacol. 2011 Apr;67(4):911-7. doi: 10.1007/s00280-010-1371-4.
  • 20. Fisher B, Bryant J, Wolmark N, et al. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998 Aug;16(8):2672-85. doi: 10.1200/JCO.1998.16.8.2672.
  • 21. Pogoda K, Niwińska A, Murawska M, Pieńkowski T. Analysis of pattern, time and risk factors influencing recurrence in triple-negative breast cancer patients. Med Oncol. 2013 Mar;30(1):388. doi: 10.1007/s12032-012-0388-4.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Cerrahi
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Pınar Taşar 0000-0002-2378-0666

Kazım Şenol 0000-0001-6273-0664

Yayımlanma Tarihi 30 Aralık 2022
Kabul Tarihi 20 Aralık 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 48 Sayı: 3

Kaynak Göster

APA Taşar, P., & Şenol, K. (2022). Üçlü Negatif Meme Kanseri Hastalarında Lokal ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 48(3), 341-347. https://doi.org/10.32708/uutfd.1205387
AMA Taşar P, Şenol K. Üçlü Negatif Meme Kanseri Hastalarında Lokal ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi. Uludağ Tıp Derg. Aralık 2022;48(3):341-347. doi:10.32708/uutfd.1205387
Chicago Taşar, Pınar, ve Kazım Şenol. “Üçlü Negatif Meme Kanseri Hastalarında Lokal Ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 48, sy. 3 (Aralık 2022): 341-47. https://doi.org/10.32708/uutfd.1205387.
EndNote Taşar P, Şenol K (01 Aralık 2022) Üçlü Negatif Meme Kanseri Hastalarında Lokal ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 48 3 341–347.
IEEE P. Taşar ve K. Şenol, “Üçlü Negatif Meme Kanseri Hastalarında Lokal ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi”, Uludağ Tıp Derg, c. 48, sy. 3, ss. 341–347, 2022, doi: 10.32708/uutfd.1205387.
ISNAD Taşar, Pınar - Şenol, Kazım. “Üçlü Negatif Meme Kanseri Hastalarında Lokal Ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 48/3 (Aralık 2022), 341-347. https://doi.org/10.32708/uutfd.1205387.
JAMA Taşar P, Şenol K. Üçlü Negatif Meme Kanseri Hastalarında Lokal ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi. Uludağ Tıp Derg. 2022;48:341–347.
MLA Taşar, Pınar ve Kazım Şenol. “Üçlü Negatif Meme Kanseri Hastalarında Lokal Ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 48, sy. 3, 2022, ss. 341-7, doi:10.32708/uutfd.1205387.
Vancouver Taşar P, Şenol K. Üçlü Negatif Meme Kanseri Hastalarında Lokal ve Bölgesel Rekürrenssiz Sağkalıma Etki Eden Faktörler: Tek Merkez Deneyimi. Uludağ Tıp Derg. 2022;48(3):341-7.

ISSN: 1300-414X, e-ISSN: 2645-9027

Uludağ Üniversitesi Tıp Fakültesi Dergisi "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License" ile lisanslanmaktadır.


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Journal of Uludag University Medical Faculty is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

2023