Prognostic value of histopathologic traits independent of stromal tumor-infiltrating lymphocyte levels in chemotherapy-naïve patients with triple-negative breast cancer
- Author(s)
- de Boo, LW; Jóźwiak, K; Ter Hoeve, ND; van Diest, PJ; Opdam, M; Wang, Y; Schmidt, MK; de Jong, V; Kleiterp, S; Cornelissen, S; Baars, D; Koornstra, RHT; Kerver, ED; van Dalen, T; Bins, AD; Beeker, A; van den Heiligenberg, SM; de Jong, PC; Bakker, SD; Rietbroek, RC; Konings, IR; Blankenburgh, R; Bijlsma, RM; Imholz, ALT; Stathonikos, N; Vreuls, W; Sanders, J; Rosenberg, EH; Koop, EA; Varga, Z; van Deurzen, CHM; Mooyaart, AL; Córdoba, A; Groen, E; Bart, J; Willems, SM; Zolota, V; Wesseling, J; Sapino, A; Chmielik, E; Ryska, A; Broeks, A; Voogd, AC; van der Wall, E; Siesling, S; Salgado, R; Dackus, GMHE; Hauptmann, M; Kok, M; Linn, SC;
- Details
- Publication Year 2024-03-06,Volume 9,Issue #3,Page 102923
- Journal Title
- ESMO Open
- Publication Type
- Research article
- Abstract
- BACKGROUND: In the absence of prognostic biomarkers, most patients with early-stage triple-negative breast cancer (eTNBC) are treated with combination chemotherapy. The identification of biomarkers to select patients for whom treatment de-escalation or escalation could be considered remains an unmet need. We evaluated the prognostic value of histopathologic traits in a unique cohort of young, (neo)adjuvant chemotherapy-naïve patients with early-stage (stage I or II), node-negative TNBC and long-term follow-up, in relation to stromal tumor-infiltrating lymphocytes (sTILs) for which the prognostic value was recently reported. MATERIALS AND METHODS: We studied all 485 patients with node-negative eTNBC from the population-based PARADIGM cohort which selected women aged <40 years diagnosed between 1989 and 2000. None of the patients had received (neo)adjuvant chemotherapy according to standard practice at the time. Associations between histopathologic traits and breast cancer-specific survival (BCSS) were analyzed with Cox proportional hazard models. RESULTS: With a median follow-up of 20.0 years, an independent prognostic value for BCSS was observed for lymphovascular invasion (LVI) [adjusted (adj.) hazard ratio (HR) 2.35, 95% confidence interval (CI) 1.49-3.69], fibrotic focus (adj. HR 1.61, 95% CI 1.09-2.37) and sTILs (per 10% increment adj. HR 0.75, 95% CI 0.69-0.82). In the sTILs <30% subgroup, the presence of LVI resulted in a higher cumulative incidence of breast cancer death (at 20 years, 58%; 95% CI 41% to 72%) compared with when LVI was absent (at 20 years, 32%; 95% CI 26% to 39%). In the ≥75% sTILs subgroup, the presence of LVI might be associated with poor survival (HR 11.45, 95% CI 0.71-182.36, two deaths). We confirm the lack of prognostic value of androgen receptor expression and human epidermal growth factor receptor 2 -low status. CONCLUSIONS: sTILs, LVI and fibrotic focus provide independent prognostic information in young women with node-negative eTNBC. Our results are of importance for the selection of patients for de-escalation and escalation trials.
- Publisher
- Elsevier
- Keywords
- fibrotic focus; lymphovascular invasion; prognostic biomarkers; stromal tumor-infiltrating lymphocytes; triple-negative breast cancer
- Department(s)
- Laboratory Research
- Publisher's Version
- https://doi.org/10.1016/j.esmoop.2024.102923
- Open Access at Publisher's Site
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Creation Date: 2024-04-02 01:27:23
Last Modified: 2024-04-02 01:33:27