Survival of women with triple negative breast cancer in Florida

Background: Tumor markers are becoming increasingly important in breast cancer (BCa) research because of their impact on prognosis, treatment, and survival. Purpose: To determine the impact of hormone receptor status and HER2 on BCa survival.

Methods: Electronic medical records from a network of 9 hospitals were linked to female BCa patients diagnosed between 2007 and 2010 in Florida. Cox proportional hazards model was used.

Results: Two-year survival of the study population was 95.1%. Median follow-up time for those who died due to BCa was 569 days. Survival functions between blacks and non-blacks were significantly different over time (p < 0.0001). Survival probability among blacks was lower than that of non-blacks. Hazard of BCa death among patients with triple negative (TN) and patients with unknown status were 4.34 and 2.35 times that of non-TN patients. Death rate among blacks was 1.6 times that of non-blacks. Other factors associated with increased hazard were: being diagnosed in regional stage or having unknown diagnosis stage, single, Medicare user, having poorly or un-differentiated tumor, with larger tumor size, and more positive nodes detected. Immediately after diagnosis, distant stage and more comorbidity conditions were associated with an elevated risk, and more lymph nodes examined was associated with reduced risk of BCa death. But these effects gradually attenuated over time.

Conclusions: Women with triple negative BCa have the worst survival outcome. This study highlights the importance of improvement of care for patients with TN biomarkers.