Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2021, Vol 37, Num, 2     (Pages: 121-129)

Clinicopathological Features and Treatment Challenges in Triple Negative Breast Cancer Patients: A Retrospective Cohort Study

Amira ELWAN 1, Aziza E. ABDELRAHMAN 2, Ahmed A. ALNAGAR 3, Mohamed I ABDELHAMID 4, Nashwa NAWAR 1

1 Department of Clinical Oncology and Nuclear Medicine, Zagazig University, Faculty of Medicine, ZAGAZIG, EGYPT
2 Department of Pathology, Zagazig University, Faculty of Medicine, ZAGAZIG, EGYPT
3 Department of Medical Oncology, Zagazig University, Faculty of Medicine, ZAGAZIG, EGYPT
4 Department of General Surgery, Zagazig University, Faculty of Medicine, ZAGAZIG, EGYPT

DOI: 10.5146/tjpath.2020.01516
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Objective: As the genetic and molecular profiles of triple negative breast carcinoma (TNBC) are elucidated, multiple therapeutic targets have been produced. TNBC with less than 1% androgen receptor (AR) expression may respond to enzalutamide with greater response association in higher levels. A metronomic dose of capecitabine and docetaxel are effective developed drugs for angiogenic process inhibition. We aimed to demonstrate the treatment outcome of triple-negative breast cancer patients in correlation to their clinicopathological features.

Materials and Methods: A retrospective cohort study of 80 TNBC patients was conducted. The patients underwent proper observation with the reporting of their treatment and follow-up data. Patients with a metastatic disease, neoadjuvant chemotherapy, follow-up drop or data shortage were excluded from the survival analysis.

Results: The study results revealed a significant association between negative androgen expression and younger age ≤35 years, premenopausal status, higher grade, extracapsular extension, lymphovascular invasion, Ki 67, and CA15-3 (p=0.003, 0.02, <0.001, 0.001, 0.027, 0.005, 0.009 respectively). The three-year overall survival (OS) in patients who received bicalutamide was better than those patients who received capecitabine or docetaxel but of no significance (p=0.46). The three-year disease free survival (DFS) was significantly better in the bicalutamide arm versus the other two groups (p=0.012).

Conclusions: We concluded that extended adjuvant antiandrogen such as bicalutamide and metronomic capecitabine are well tolerated with accepted compliance and affordability compared to docetaxel and are warranted for problem-solving and better DFS and OS in some TNBC patients.

Keywords : Triple negative breast cancer, Androgen receptor, Capecitabine, Bicalutamide