Impact of triple-negative breast cancer on management of the axilla / Khalid Omar Omar Muhammad Alhameedy ; Supervised Hassan Mahmoud Abdalla , Iman Loay Hussein , Ahmed Mohamed Farahat

Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Oncology (Surgical)

Background: Lymph node status and pathologic features of the primary tumor are used to estimate a patient{u2019}s prognosis and guide the selection of adjuvant therapy. {u2018}Triple-negative{u2019} breast cancer (TNBC) accounts for {u223C}15% of all breast cancer cases and is generally associated with a poor prognosis. However, studies have documented that frequency of lymph node metastasis was lower in patients with triple-negative tumors than the other types, despite the biologically aggressive behavior. Objective: To assess the incidence of nodal affection in patients with a certain biological behavior (Triple-negative vs. non-Triple-negative). Methods: This is a retrospective study from the records of NCI for the years 2013-2014. The study will compare between nodal metastasis in female patients of any age with Triple-Negative and Non-Triple-Negative breast cancer, excluding those who received neoadjuvant chemotherapy and those with metastatic disease. Results: A total of 371 patients were included in the study. The breakdown by subtype included 77 patients of the TNBC phenotype (20.8%) vs. 294 (79.2%) in the non-TNBC group. When comparing TNBC vs. non-TNBC, the lymph node positivity rate was found to be 42 of 77 (54.6%) in TNBC, while for non-TNBC, it was 203 of 294 (69.1%), which was statistically significant with a p value of 0.009. Conclusion: Triple-negative breast cancer is biologically aggressive, but it is not associated with lymphatic spread, and so addressing the axilla in TNBC should not differ from non-TNBC, because aggressive surgery cannot correct an aggressive biology

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