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Risk factors identified for locoregional recurrence in triple-negative breast cancer
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Increasing age and the presence of lymphovascular invasion were among several predictors of locoregional recurrence in a cohort of women with triple-negative breast cancer.
The study included 390 women with triple-negative disease with T1/T2 tumors who had zero to three positive lymph nodes (pathologic T1-T2N0-N1). Eligible patients underwent modified radical mastectomy without postmastectomy radiation therapy.
Researchers wanted to assess patterns of failure and predictive factors for locoregional recurrence that could justify postmastectomy radiation.
Patients treated between January 2000 and July 2007 were included. The median follow-up duration was 60.5 months.
The overall rate of chemotherapy was 86.4%.
Researchers reported the following rates at 5 years: local recurrence, 5.4%; regional recurrence, 4.7%; locoregional recurrence, 8%; and distant metastasis, 13.4%.
Multivariable analysis showed increased risk for locoregional recurrence was significantly associated with several factors, including age younger than 50 years, the presence of lymphovascular invasion, grade 3 tumors and the presence of three involved lymph nodes.
Locoregional recurrence rates at 5 years were 4.2% for patients with zero or one risk factor, 25.2% for those with two risk factors, and 81% for those with three or four risk factors (P<.0001).
Statistically significant predictors of regional recurrence included the presence of lymphovascular invasion and having three involved lymph nodes.
Patients with regional recurrence were significantly more likely to experience distant metastases than those who had local recurrence (59.1% vs. 20.9%, P<.0001).
The researchers concluded that postmastectomy radiation should be considered for patients with two or more of the observed risk factors.
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