[285] Lymph Node Status of Triple Negative Breast Carcinoma: Results of a Large Cohort Study.
Yong Hannah Wen, Gaorav Gupta, Zenica Bowser, Alice Ho, Edi Brogi. Memorial Sloan-Kettering Cancer Center, New York, NY
Background: Few studies have reported on the rate of axillary lymph node (LN) involvement at presentation of triple negative breast carcinoma (TNBC) compared to other subtypes.
Design: We mined the 2001-2010 hospital database for age, size and LN status of pts with BC, to assess rate and extent of LN metastasis of TN compared to other BC. Pts with stage IV disease, neoadjuvant therapy, or unknown LN status were excluded.
Results: Our search yielded 13,626 BC, including 1957 TN, 9698 ER/PR(+)/HER2(-) (Lum A), 1177 ER/PR(+)/HER2(+) (Lum B) and 794 ER/PR(-)/HER2(+) (HER2). Out of 11801 pts with sentinel (SLN) biopsy, 4113 (34.9%) were SLN(+). TN had fewer SLN(+) (28.5%) than other BC (35.3% Lum A, 39.0% Lum B, 37.6% HER2; p=0.0001). 5812 pts (42.7%) were LN(+). The overall rate of LN(+) in TN was similar to that in Lum A (41.5% vs 41.3%), and lower than that in Lum B (50.0%) or HER2 (51.1%) BC (p=0.0001). Pts with T1 TNBC had ≥4 LNs(+) more often than pts with T1 Lum A BC (7.3% vs 4.6%, p=0.0001), but T2 and T3 TN pts had lower rate of both LN(+) and >=4 LN)(+) than all other pts with BC.
| All BC | TN | Lum A | Lum B | HER2 | |
| N (%) | 13626 | 1957 (14.4%) | 9698 (71.2%) | 1177 (8.6%) | 794 (5.8%) |
| Mean age (range), y | 56 (19-96) | 54 (19-89) | 57 (19-96) | 52 (22-89) | 53 (25-89) |
| Mean size, mm | 18 | 22 | 17 | 37 | 32 |
| LN (+) | 42.7% | 41.5% | 41.3% | 50.0%* | 51.1%* |
| SLN (+), n=11801 | 34.9% | 28.5% | 35.3%* | 39.0%* | 37.6%* |
| # LN (+) | T1 | T2 | T3 | Total | |
| TN | 0 | 816/1164 (70%) | 301/692 (44%) | 27/91 (30%) | 59% |
| 1-3 | 263/1164 (23%) | 251/692 (36%) | 24/91 (26%) | 28% | |
| >=4 | 85/1164 (7%) | 140/692 (20%) | 40/91 (44%) | 14% | |
| Lum A | 0 | 5040/7378 (68%) | 621/2056 (30%)* | 25/236 (11%)* | 59% |
| 1-3 | 2001/7378 (27%) | 920/2056 (45%) | 77/236 (33%) | 31% | |
| >=4 | 337/7378 (5%)* | 515/2056 (25%)** | 134/236 (57%)** | 10%* | |
| Lum B | 0 | 489/780 (63%)* | 98/352 (28%)* | 1/40 (2.5%)* | 50%* |
| 1-3 | 234/780 (30%) | 148/352 (42%) | 8/40 (20%) | 33% | |
| >=4 | 57/780 (7%) | 106/352 (30%)* | 31/40 (77.5%)* | 17%** | |
| HER2 | 0 | 312/521 (60%)* | 72/245 (29%)* | 3/23 (13%) | 49%* |
| 1-3 | 148/521 (28%) | 89/245 (36%) | 2/23 (9%) | 31% | |
| >=4 | 61/521 (12%)** | 84/245 (34%)* | 18/23 (78%)** | 21%* |