Recurrence in Stage I and II Triple-Negative Breast Cancer: Analysis of Clinicopathologic and Imaging Factors

Abstract Background To describe the outcomes of patients with early stage triple-negative breast cancer (TNBC) and to investigate whether certain imaging and clinicopathologic factors were associated with recurrence in patients with early stage TNBC. Methods We identified stage I and II TNBC patients treated between 2009 and 2011. Data included patient and tumor characteristics, time of recurrence, and findings on mammography, ultrasonography, and magnetic resonance imaging (MRI). Kaplan-Meier method was used to estimate recurrence free survival and Cox proportional hazards model was used to determine the association between imaging and clinicopathologic factors and recurrence. Results The study included 702 patients with mean age of 49.0 years (range, 24–82 years) and mean follow-up of 61 months (range, 6 - 93 months). Overall, 115 (115/702, 16.4%) had recurrence. Clinicopathologic factors associated with recurrence included increasing tumor size, positive nodal status, ki-67 index more than 14, presence of lymphovascular invasion (LVI), mastectomy, and neoadjuvant or adjuvant chemotherapy. Imaging factors associated with recurrence included moderate or marked background parenchymal enhancement on MRI. After controlling for all potential confounders, tumor size, nodal status, LVI, and adjuvant chemotherapy were independently associated with recurrence. Conclusion Sixteen percent of patients with early stage TNBC experienced recurrence, with 3 and 5 year recurrence rates being 12.4% and 15.3%, respectively. Tumor size, nodal status, LVI, and adjuvant chemotherapy were independently associated with recurrence, while none of the imaging factors showed association.