Background and purpose: Triple negative breast cancer (TNBC) is a high risk breast cancer characterized by the negative expression of estrogen receptor(ER), progesterone receptor (PR) and Her-2 that have no specific therapy. This study was to analyze clinical pathological characteristics, survival, and prognostic factors of patients with TNBC. Methods: Clinical and pathological as well as follow-up data of TNBC, treated at the Cancer Centre of Sun Yat-sen University from Jan. 2000 to Dec. 2003, were collected and analyzed. Results: A total number of 128 women were identified as having triple negative breast cancer. The median age of these patients was 46 years, and 60.9% of them had stage Ⅰ or Ⅱ disease. The majority of pathological types were invasive ductal carcinomas, and 78.1% of tumors were staged T1 or T2. And 48.4% of these patients were involved in lymph node. Event-free survival, local replase-free survival, distant metastasis-free survival and overall survival at five years were 71.1%, 84.3%, 75.8% and 83.6% respectively. Though lymph node metastasis, tumor masses, stage and lymph-vascular invasion were all found to be related to overall survival, however, only lymph node metastasis and tumor masses affected the overall survival as revealed by the Cox proportional hazard model analysis. Conclusion: Triple negative breast cancer has distinct clinical and pathological characteristics. The patients are usually young, with large masses, lymph node metastasis, family history of breast cancer and poor prognosis; lymph node metastasis and tumor mass are important prognostic factors.%背景与目的:三阴性乳腺癌(triple negative breast cancer,TNBC)是一类高危乳腺癌,其雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone,PR)和入表皮生长因子受体2(human epidermal growth factor receptor-2.Her-2)表达均为阴性,因而不能从针对激素受体的内分泌治疗和Her-2的靶向治疗中获益.本研究旨在分析TNBC患者的临床病理特征、生存情况和预后影响因素.方法:收集免疫组织化学检测ER、PR和Her-2均为阴性的128例乳腺癌患者的临床病理资料,观察其长期生存情况.结果:所有患者中,浸润性导管癌占89.0%.T1、T2患者占78.1%,有淋巴结转移的患者占48.4%,Ⅰ、Ⅱ期患者占60.9%.5年无病生存率、无局部复发生存率、无远处转移生存率和总生存率分别为71.1%、84.3%、75.8%和83.6%.单因素分析结果显示,淋巴结转移、肿块大小、分期和脉管癌栓与TNBC预后有关.多因素分析显示,淋巴结转移(RR=17.449,P=0.000)、原发肿块大小(RR=31.237,P=0.000)是影响TNBC预后的因素.结论:TNBC有明显不同的临床病理特征,发病时常年轻、有淋巴结转移、肿块较大,有乳腺癌家族史,预后差,淋巴结转移和肿块大小是影响TNBC预后的因素.
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