Refereed journal article or data article (A1)
Varying outcomes of triple-negative breast cancer in different age groups-prognostic value of clinical features and proliferation
List of Authors: Vihervuori Hilda, Korpinen Katarina, Autere Tuomi-Artturi, Repo Heli, Talvinen Kati, Kronqvist Pauliina
Publisher: SPRINGER
Publication year: 2022
Journal: Breast Cancer Research and Treatment
Journal name in source: BREAST CANCER RESEARCH AND TREATMENT
Journal acronym: BREAST CANCER RES TR
Volume number: 196
Issue number: 3
Start page: 471
End page: 482
Number of pages: 12
ISSN: 0167-6806
eISSN: 1573-7217
DOI: http://dx.doi.org/10.1007/s10549-022-06767-1
URL: http://dx.doi.org/10.1007%2Fs10549-022-06767-1
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/177016342
Purpose
Triple-negative breast cancer (TNBC) is an aggressive disease lacking specific biomarkers to guide treatment decisions. We evaluated the combined prognostic impact of clinical features and novel biomarkers of cell cycle-progression in age-dependent subgroups of TNBC patients.
Methods
One hundred forty seven TNBC patients with complete clinical data and up to 18 year follow-up were collected from Turku University Hospital, Finland. Eight biomarkers for cell division were immunohistochemically detected to evaluate their clinical applicability in relation to patient and tumor characteristics.
Results
Age at diagnosis was the decisive factor predicting disease-specific mortality in TNBC (p = 0.002). The established prognostic features, nodal status and Ki-67, predicted survival only when combined with age. The outcome and prognostic features differed significantly between age groups, middle-aged patients showing the most favorable outcome. Among young patients, only lack of basal differentiation predicted disease outcome, indicating 4.5-fold mortality risk (p = 0.03). Among patients aged > 57, the established prognostic features predicted disease outcome with up to 3.0-fold mortality risk for tumor size ≥ 2 cm (p = 0.001). Concerning cell proliferation, Ki-67 alone was a significant prognosticator among patients aged > 57 years (p = 0.009). Among the studied cell cycle-specific biomarkers, only geminin predicted disease outcome, indicating up to 6.2-fold increased risk of mortality for tumor size < 2 cm (p = 0.03).
Conclusion
Traditional clinical features do not provide optimal prognostic characterization for all TNBC patients. Young age should be considered as an additional adverse prognostic feature in therapeutic considerations. Increased proliferation, as evaluated using Ki-67 or geminin immunohistochemistry, showed potential in detecting survival differences in subgroups of TNBC.
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