Histo-and clinico-pathological analysis of a large series of triple-negative breast cancer in a sing

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Objective: To investigate hisro-pathological distribution and clinico-pathological significance in a large Chinese triple-negative breast cancer (TNBC) patients serials based on the latest understanding of its clinico-pathological diversity,and to provide more information to clinicians to improve precision of individualized treatment of TNBC.Methods: A retrospective analysis was performed on patients with TNBC at Breast Disease Center,Peking University First Hospital between January 2010 and December 2019.Histo-and clinico-pathological characteristics were analyzed by Chi-square test and Student's t-test,and prognoses were calculated using Kaplan-Meier method and a Cox proportionate hazards model.Bonferroni correction was used to correct for multiple comparison.Results: Conventional type of TNBC (cTNBC) were identified in 73.7% of 582 TNBC,while special type of TNBC (sTNBC) were 26.3%,including 71 apocrine carcinoma,20 medullary carcinoma,31 metaplastic carcinoma,18 invasive lobular carcinoma,7 invasive micropapillary carcinoma,5 adenoid cystic carcinoma and 1 acinic cell carcinoma.Compared to sTNBC,cTNBC was associated with high histologic grade (P<0.001) and lower androgen receptor (AR) expression (P<0.001).TNM stage of low-grade cTNBC was significantly lower than that of high-grade cTNBC (P=0.002).Although no significant difference,there was a trend that the rate of 5-year disease-free survival (DFS) and 5-year overall survival (OS) were longer in high-grade cTNBC than in high-grade sTNBC (P=0.091 and 0.518),and were longer in low-grade sTNBC than in high-grade sTNBC (P=0.051 and 0.350).Metaplastic carcinomas showed larger tumor size (P=0.008) and higher proliferative Ki67 index (P=0.004)than cTNBCs.Conclusions: Results from our cohort imply that sub-categorization or subtyping and histological grading could be meaningful in pathological evaluation of TNBC,and need to be clarified in more large collections of TNBC.
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