The treatment and survival of patients with triple negative breast cancer in a London population

PURPOSE Triple negative breast cancer (TNBC) constitutes 10-15% of female breast cancers, and clinical guidelines recommend treatment with chemotherapy and surgery. We examined the recorded treatment and survival of women with TNBC in a population-based sample within the UK. METHODS Cancer registration data for North East London women diagnosed between 2005 and 2007 were supplemented with pathology data on hormone receptor status to determine triple negative status. Receipt of surgery, chemotherapy, radiotherapy, hormone therapy, or surgery plus chemotherapy according to TNBC status was assessed using logistic regression, and adjusted for age, stage of disease and socioeconomic deprivation. Five-year survival according to TNBC status and treatment was estimated using the Kaplan-Meier method and Cox regression analysis examined adjusted all-cause mortality. RESULTS Triple negative status could be determined for 1228 of 2394 women with breast cancer and 128 (10%) had TNBC. Compared to patients without TNBC, patients with TNBC were more likely to receive chemotherapy (fully adjusted odds ratio (OR) =4.21, 95% confidence interval (CI) 2.63-6.75) or surgery plus chemotherapy (fully adjusted OR = 2.52, 95% CI 1.61-3.93). Of patients with TNBC, those who received surgery plus chemotherapy had the greatest 5-year survival estimate (0.74, 95% CI 0.60-0.83). Overall, patients with TNBC had a higher risk of death (fully adjusted hazard ratio (HR) =1.69, 95% CI 1.24-2.30) compared to those without TNBC. CONCLUSIONS This population-based study found that despite women with TNBC being more likely to receive chemotherapy, or surgery plus chemotherapy, they had a poorer overall survival than with those without TNBC.