J Breast Cancer.  2015 Sep;18(3):271-278. 10.4048/jbc.2015.18.3.271.

Evaluation of the Survival Benefit of Different Chemotherapy Regimens in Patients with T1-2N0 Triple-Negative Breast Cancer

• Kim HA
• Seong MK
• Kim EK
• Kang E
• Park S
• Hur MH
• Song BJ
• Noh WC
• Korea Breast Cancer Society

• KMID: 2407575
• DOI: http://doi.org/10.4048/jbc.2015.18.3.271

Abstract

PURPOSE
This study aimed to evaluate the survival benefit of different adjuvant chemotherapy regimens in patients with T1-2N0 triple-negative breast cancer.
METHODS
Of 67,321 patients who were registered in the Korean Breast Cancer Society nationwide database between January 1999 and December 2008, 4,033 patients with T1-2N0 triple-negative breast cancer were included. The overall survival of patients who did not receive adjuvant chemotherapy was compared with those treated with adjuvant anthracycline and cyclophosphamide (AC), 5-fluorouracil, anthracycline, and cyclophosphamide (FAC), or cyclophosphamide, methotrexate, and 5-fluorouracil (CMF).
RESULTS
The median follow-up was 52.5 months. Chemotherapy was used in 87.4% of patients; it was used more commonly in patients with T2 tumors, those who were younger, had a higher histologic grade, and who showed lymphovascular invasion. The 5-year cumulative overall survival rate was 95.4%. Younger age, breast-conserving surgery, and adjuvant chemotherapy were significantly associated with improved overall survival. The 5-year cumulative overall survival rate of patients who did not receive adjuvant chemotherapy and those treated with AC, FAC, and CMF were 92.5%, 95.9%, 95.3%, and 95.9%, respectively. On multivariate analysis, the administration of any adjuvant chemotherapy regimen was significantly associated with improved overall survival (p=0.038). No significant difference in survival benefit was observed among the three different treatment groups.
CONCLUSION
A standard adjuvant chemotherapy regimen with the least drug-related toxicity might be a reasonable treatment for patients with T1-2N0 triple-negative breast cancer.

Keyword

Adjuvant chemotherapy; Lymph nodes; Survival; Triple negative breast neoplasms

MeSH Terms

Breast Neoplasms
Chemotherapy, Adjuvant
Cyclophosphamide
Drug Therapy*
Fluorouracil
Follow-Up Studies
Humans
Lymph Nodes
Mastectomy, Segmental
Methotrexate
Multivariate Analysis
Survival Rate
Triple Negative Breast Neoplasms*
Cyclophosphamide
Fluorouracil
Methotrexate

Figure

• 

  Figure 1 Study design. IDC=invasive ductal carcinoma; ILC=invasive lobular carcinoma; ER=estrogen receptor; PR=progesterone receptor; HER2=human epidermal growth factor receptor 2; CMF=cyclophosphamide, methotrexate, and 5-fluorouracil; FAC=5-fluorouracil, anthracycline, and cyclophosphamide; AC=anthracycline and cyclophosphamide.

• 

  Figure 2 Overall survival of all patients.

• 

  Figure 3 Overall survival according to the chemotherapy regimen used. The receiving adjuvant chemotherapy showed beneficial effect on overall survival compared with not receiving adjuvant chemotherapy. There was no significant difference in the survival rates between the chemotherapy regimens employed. CMF=cyclophosphamide, methotrexate, and 5-fluorouracil; FAC=5-fluorouracil, anthracycline, and cyclophosphamide; AC=anthracycline and cyclophosphamide.

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