Metastatik olmayan triple negatif meme kanseri hastalarının retrospektif değerlendirilmesi
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Dosyalar
Tarih
2023
Kurum Yazarları
Bozdağ, Büşra Güner
Süreli Yayın başlığı
Süreli Yayın ISSN
Cilt Başlığı
Yayınevi
Bursa Uludağ Üniversitesi
Özet
Triple negatif meme kanseri (TNMK), meme kanserleri alt grubunda sınıflandırılan ER, PR ve HER2 eksprese etmeyen biyolojik davranışları açısından önemli farklılıklar gösteren nadir, heterojen bir neoplazm grubudur. Kemoterapiye cevap verse de nüks ve kemorefrakter hastalık sıklıkla karşımıza çıkmaktadır. Bu çalışmada, metastazı olmayan ve neoadjuvan kemoterapi almayan TNMK hastalarının klinik ve patolojik özelliklerini retrospektif olarak incelemeyi amaçladık. Çalışmamıza Ocak 2010-Ağustos 2018 tarihleri arasında Bursa Uludağ Üniversitesi Tıp Fakültesi Onkoloji Kliniği'ne başvuran 104 triple nagatif meme kanseri hastası dahil edilmiştir. Çalışmamız retrospektif bir kohort çalışmasıdır. Hastaların yaş, cinsiyet, patolojik alt tipleri, tanı tarihleri, operasyon tarihleri, tedavileri, son takip ve/veya ölüm tarihleri belirlenmiş ve karşılaştırmalı analizler planlanmıştır. Çalışmamıza katılan 104 kadın hastanın; 96'sı (%92,3) invaziv duktal karsinom, beşi (%4,8) mikst metaplazik karsinoma, ikisi (%1,9) apokrin karsinom, biri (%1) glikojenden zengin karsinomaydı. 94 hasta (%90,4) adjuvan kematerapi almıştı, 10'u (%9,6) operasyon sonrası kemoterapi tedavisi almamıştı. 26 hasta (%25) nüks olmuştu. Bunların 17'si (%17) lokal, dokuzu (%8,7) uzak metastazdı. Nüks subtipi hastaların 18'inde (%17,3) triple negatif, sekizinde (%7,7) hormon pozitif, HER2 negatif olup luminal grup saptanmıştı. Çalışmamızda Evre-1 olan 33 hastadan kemoterapi tedavi verilmeden takip edilen beş hastada aksillar ve sentineal lenf nodu metastazı bulunmadı, hastalarda exitus veya nüks gelişmedi (p>0,05). Evre-2 olan 57 hastadan tedavi verilmeden takip edilen beş hastanın dördünde exitus veya nüks gelişmedi. Kemoterapi tedavisi uygulanan 52 hastanın 12'sinde nüks veya ex gelişti. Evre-2 hasta gurubunda kemoterapinin hastalıksız sağ kalım süresine etkisi istatistiksel olarak anlamlı saptandı (p<0,001). Adjuvan kemoterapi tedavisi almadan takip edilen hasta grubunda HSS 70,6 ay saptandı. Kemoterapi tedavisi alan hasta grubunda median değere ulaşılamadı. Evre-1 ve Evre-2 olan (90 hasta); antrasiklin ve taksan bazlı kemoterapi içeren rejim tercih edilen hastalarda HSS, istatistik olarak anlamlı daha uzun saptandı (p=0,029). Çalışmamızda hastalıksız sağ kalım analizi sonuçları kapsamında; evre yükseldikçe HSS azalmıştır. Evre-1 ve Evre-2 hasta grubunda median değere ulaşılamamıştır. Evrenin, hastalıksız sağkalıma istatistiksel olarak anlamlı bir etkisi gözlenmiştir (p=0,02).
Triple negative breast cancer is a rare subgroup of cancers classified within the subgroup of breast cancers that do not express ER, PR, and HER2, with significant differences in biological behavior. Although it responds to chemotherapy, recurrence and chemorefractory disease are frequently encountered. In this study, we aimed to retrospectively analyze the clinical and pathologic features of TNBC patients without metastases who did not receive neoadjuvant chemotherapy. We included 104 triple-negative breast cancer patients admitted to the Oncology Clinic of Bursa Uludag University Faculty of Medicine, Bursa, between January 2010 and August 2018. Our study is a retrospective cohort study. Age, gender, pathologic subtypes, diagnosis dates, operation dates, treatments, last follow-up and/or death dates of the patients were determined, and comparative analyses were planned. Among the 104 female patients who participated in our study; 96 patients (92.3%) had invasive ductal carcinoma, 5 patients (4.8%) had mixed metaplastic carcinoma, 2 patients (1.9%) had apocrine carcinoma, and 1 patient (1%) had glycogen-rich carcinoma. 94 patients (90.4%) received adjuvant chemotherapy, while 10 patients (9.6%) did not receive postoperative chemotherapy. 26 patients (25.0%) experienced recurrence. Of these, 17 patients (17%) had local metastasis, and 9 patients (8.7%) had distant metastasis. The recurrence subtype was triple negative in 18 patients (17.3%), hormone-positive in 8 patients (7.7%), HER2 negative, and in the luminal group. In our study, 5 out of 33 patients with Stage-1 were followed up without chemotherapy, and no axillary and sentinel lymph node metastasis was found, with no exitus or recurrence developed (p>0.05). Out of 57 stage-2 patients, 5 patients were followed up without chemotherapy, and 4 of them developed exitus or recurrence. Of the 52 patients who received chemotherapy treatment, 12 developed recurrence or ex. The effect of chemotherapy on DFS in the stage-2 patient group was statistically significant (p<0.001). The overall survival (OS) was 70.6 months in the patient group who were followed up without adjuvant chemotherapy. The median value could not be reached in the patient group who received chemotherapy treatment. DFS was significantly longer in patients with stage-1 and stage-2 (90 patients) who received an anthracycline and taxane-based chemotherapy regimen (p=0.029). Within the scope of the results of DFS analysis in our study; DFS decreased as the stage increased. Median values could not be reached in stage 1 and stage 2 patient groups. A statistically significant effect of stage on DFS was observed (p=0.02).
Triple negative breast cancer is a rare subgroup of cancers classified within the subgroup of breast cancers that do not express ER, PR, and HER2, with significant differences in biological behavior. Although it responds to chemotherapy, recurrence and chemorefractory disease are frequently encountered. In this study, we aimed to retrospectively analyze the clinical and pathologic features of TNBC patients without metastases who did not receive neoadjuvant chemotherapy. We included 104 triple-negative breast cancer patients admitted to the Oncology Clinic of Bursa Uludag University Faculty of Medicine, Bursa, between January 2010 and August 2018. Our study is a retrospective cohort study. Age, gender, pathologic subtypes, diagnosis dates, operation dates, treatments, last follow-up and/or death dates of the patients were determined, and comparative analyses were planned. Among the 104 female patients who participated in our study; 96 patients (92.3%) had invasive ductal carcinoma, 5 patients (4.8%) had mixed metaplastic carcinoma, 2 patients (1.9%) had apocrine carcinoma, and 1 patient (1%) had glycogen-rich carcinoma. 94 patients (90.4%) received adjuvant chemotherapy, while 10 patients (9.6%) did not receive postoperative chemotherapy. 26 patients (25.0%) experienced recurrence. Of these, 17 patients (17%) had local metastasis, and 9 patients (8.7%) had distant metastasis. The recurrence subtype was triple negative in 18 patients (17.3%), hormone-positive in 8 patients (7.7%), HER2 negative, and in the luminal group. In our study, 5 out of 33 patients with Stage-1 were followed up without chemotherapy, and no axillary and sentinel lymph node metastasis was found, with no exitus or recurrence developed (p>0.05). Out of 57 stage-2 patients, 5 patients were followed up without chemotherapy, and 4 of them developed exitus or recurrence. Of the 52 patients who received chemotherapy treatment, 12 developed recurrence or ex. The effect of chemotherapy on DFS in the stage-2 patient group was statistically significant (p<0.001). The overall survival (OS) was 70.6 months in the patient group who were followed up without adjuvant chemotherapy. The median value could not be reached in the patient group who received chemotherapy treatment. DFS was significantly longer in patients with stage-1 and stage-2 (90 patients) who received an anthracycline and taxane-based chemotherapy regimen (p=0.029). Within the scope of the results of DFS analysis in our study; DFS decreased as the stage increased. Median values could not be reached in stage 1 and stage 2 patient groups. A statistically significant effect of stage on DFS was observed (p=0.02).
Açıklama
Anahtar kelimeler
Meme, Triple negatif meme kanseri, Hastalıksız sağkalım süresi, Nüks, Kemoterapi, Breast, Triple negative breast cancer, Disease-free survival, Recurrence, Chemotherapy
Alıntı
Bozdağ, B. G. (2023). Metastatik olmayan triple negatif meme kanseri hastalarının retrospektif değerlendirilmesi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.