Opportunities for improving triple-negative breast cancer outcomes: results of a population-based study

Article Article scientifique Article Opportunities for improving triple-negative breast cancer outcomes: results of a population-based study eng 2017 author Rapiti Aylward Elisabetta 134294 author Pinaud Kim 688932 author Chappuis Pierre 26922 author Viassolo Valeria 847816 author Ayme Aurélie 662856 author Neyroud Isabelle 23009 author Usel Massimo 22657 author Bouchardy Magnin Christine 27853 526-536 10.1002/cam4.998 28211614 2045-7634 Triple-negative breast cancer (TNBC) is associated with a poor prognosis. Surgery, radiotherapy, chemotherapy, and referral for genetic counseling are the standard of care. We assessed TNBC prevalence, management, and outcome using data from the population-based Geneva cancer registry. 2591 women had a first invasive stage I-III breast cancer diagnosed between 2003 and 2011. We compared TNBC to other breast cancers (OBC) by χ(2) -test and logistic regression. Kaplan-Meier survival curves, up to 31-12-2014, were compared using log-rank test. TNBC risk of mortality overall (OS) and for breast cancer (BCSS) was evaluated through Cox models. Linkage with the Oncogenetics and Cancer Prevention Unit (OCPU) database of the Geneva University Hospitals provided genetic counseling information. TNBC patients (n = 192, 7.4%) were younger, more often born in Africa or Central-South America than OBC, had larger and more advanced tumors. 18% of TNBC patients did not receive chemotherapy. Thirty-one (17%) TNBC women consulted the OCPU, 39% among those aged <40 years. Ten-year survival was lower in TNBC than OBC (72% vs. 82% for BCSS; P < 0.001; 80% vs. 91% for OS; P < 0.001). The mortality risks remained significant after adjustment for other prognostic variables. The strongest determinants of mortality were age, place of birth, and lymph node status. A substantial proportion of TNBC patients in Geneva did not receive optimal care. Over 60% of eligible women did not receive genetic counseling and 18% did not receive chemotherapy. To improve TNBC prognosis, comprehensive care as recommended by standard guidelines should be offered to all patients. Chemotherapy Genetic Counseling Population-Based Study Survival Triple-Negative Breast Cancer Dewey 613 Dewey 616.07 Dewey 616 Autre Swiss League against Cancer grant no. KFS-29 46-02-2012 137 Département de pathologie et immunologie 21F 56 Département de médecine 221 215 Registre genevois des tumeurs 22A12 false 1311 Epidémiologie des tumeurs 1017 277 Groupe Bouchardy Magnin Christine (Registre genevois des tumeurs) 532 Cancer Medicine 6 3 743fa080-d986-4bbe-a217-75b69f926149 Article (Published version) Public opportunities.pdf 194689 application/pdf CC BY openAccess Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de santé globale / Registre genevois des tumeurs

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