Journal Article
. 2013 Dec;4(6).
doi: 10.4021/wjon738w.

TNBC vs. Non-TNBC: A Five-Year Retrospective Review of Differences in Mean Age, Family History, Smoking History and Stage at Diagnosis at an Inner City University Program

Khurram Tariq 1 Fauzia Rana 2 
Affiliations
  • PMID: 29147364
  •     67 References
  •     6 citations

Abstract

Background: In recent years, breast cancer has been classified on the basis of estrogen or progesterone receptor (ER/PR) status and whether the human epidermal growth factor 2 receptor (HER2/neu) protein is overexpressed. Based on this system, breast cancer is broadly divided into the triple negative breast cancer (TNBC) and the non-TNBC subtypes. TNBC is a subtype of breast cancer, notable for its propensity to metastasize early and display a comparatively more aggressive course than its non-TNBC counterpart. Certain clinico-pathologic and demographic risk factors have been associated with breast cancer. In this study, we aim to compare mean age, ethnicity, family history, tobacco use and stage at presentation between TNBC and non-TNBC subtypes at our inner city university program.

Methods: We reviewed data in our tumor registry between January 2000 and December 2005 with particular attention to mean age, race, family history, tobacco use and stage at presentation. We found a total of 445 patients with various subtypes of breast cancers. We included only those patients in whom the status of both ER/PR and the status of Her2/neu protein overexpression were recorded. Our strict selection criteria lead to an exclusion of about 103 patients. Out of the remaining 342 patients, 39 were TNBC and 303 were non-TNBC.

Results: Mean age of onset for TNBC vs. non-TNBC patients was 59.87 ± 15.67 years vs. 60.09 ± 13.98 years respectively (P = 0.9272). In terms of ethnicity, TNBC vs. non-TNBC patients had the following racial backgrounds: black, 58.97% vs. 39.27%; white, 35.90% vs. 57.76%; Chinese, 2.56% vs. 0.99%; others, 2.57% vs. 1.98% respectively (P = 0.004, OR = 2.755). Comparisons with respect to a history of tobacco abuse for TNBC vs. non-TNBC patients revealed a positive smoking history in 20.51% vs. 27.72% whereas there was no former or current smoking history in 71.79% vs. 61.72% respectively (P = 0.4385). Comparison of family history of a breast cancer in TNBC vs. non-TNBC patients showed that positive family history of breast cancer was seen in 30.77% vs. 33.33%, no family history of cancer was seen in 51.28% vs. 51.82% and unknown 17.95% vs. 14.85% (P = 0.8384). Pathologic stage at the time of diagnosis for TNBC vs. non-TNBC patients was as follows: stage 0, 15.79% vs. 11.37% (P = 0.4332); stage 1, 34.21% vs. 30.98% (P = 0.6890); stage 2, 28.98% vs. 37.25% (P = 0.3205); stage 3, 18.42% vs. 17.25% (P = 0.0.8591); and stage 4, 3.63% vs. 3.14% (P = 0.8651). Analysis using Chi-square test revealed χ2 value of 0.855.

Conclusion: Our results add to the growing body of evidence pertaining to the association of certain demographic and clinico-pathologic characteristics in women with breast cancer. We found that in our patient population, there is a significant ethnic predisposition for the two types of breast cancers that we studied. African Americans were more likely to have TNBC compared to the higher frequency of non-TNBC in white females. We did not find a significant difference in mean age, cigarette smoking, family history and stage at diagnosis between the TNBC and non-TNBC breast cancer patients. These findings are all consistent with the previously published research studies.

Keywords: Breast cancer; Demographical differences; Non-TNBC; TNBC.

Prognostic value of proliferation assay in the luminal, HER2-positive, and triple-negative biologic classes of breast cancer.
Mohammed A Aleskandarany, Andrew R Green, +5 authors, Emad A Rakha.
Breast Cancer Res, 2012 Jan 10; 14(1). PMID: 22225836    Free PMC article.
Social class is an important and independent prognostic factor of breast cancer mortality.
Christine Bouchardy, Helena M Verkooijen, Gérald Fioretta.
Int J Cancer, 2006 Mar 25; 119(5). PMID: 16557599
A review of triple-negative breast cancer.
Roohi Ismail-Khan, Marilyn M Bui.
Cancer Control, 2010 Jul 29; 17(3). PMID: 20664514
Review.
Widening disparity in survival between white and African-American patients with breast carcinoma treated in the U. S. Department of Defense Healthcare system.
Ismail Jatoi, Heiko Becher, Charles R Leake.
Cancer, 2003 Aug 28; 98(5). PMID: 12942554
Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007.
Benjamin O Anderson, Cheng-Har Yip, +6 authors, Joe Harford.
Cancer, 2008 Sep 26; 113(8 Suppl). PMID: 18816619
Highly Cited.
Prognostic significance of young age (<35 years) by subtype based on ER, PR, and HER2 status in breast cancer: a nationwide registry-based study.
Eun-Kyu Kim, Woo Chul Noh, Wonshik Han, Dong-Young Noh.
World J Surg, 2011 Apr 08; 35(6). PMID: 21472372
Understanding and treating triple-negative breast cancer.
Carey Anders, Lisa A Carey.
Oncology (Williston Park), 2008 Nov 05; 22(11). PMID: 18980022    Free PMC article.
Highly Cited. Review.
Systemic excretion of benzo(a)pyrene in the control and microsomally induced rat: the influence of plasma lipoproteins and albumin as carrier molecules.
H P Shu, E N Bymun.
Cancer Res, 1983 Feb 01; 43(2). PMID: 6293698
The antiestrogenic effect of cigarette smoking in women.
J A Baron, C La Vecchia, F Levi.
Am J Obstet Gynecol, 1990 Feb 01; 162(2). PMID: 2178432
Highly Cited. Review.
Breast-conservation therapy in early-stage breast cancer patients with a positive family history.
Georges Vlastos, Nadeem Q Mirza, +11 authors, S Eva Singletary.
Ann Surg Oncol, 2002 Nov 06; 9(9). PMID: 12417515
High-throughput protein expression analysis using tissue microarray technology of a large well-characterised series identifies biologically distinct classes of breast cancer confirming recent cDNA expression analyses.
Dalia M Abd El-Rehim, Graham Ball, +6 authors, Ian O Ellis.
Int J Cancer, 2005 Apr 09; 116(3). PMID: 15818618
Highly Cited.
Cigarette smoking, serum estrogens, and bone loss during hormone-replacement therapy early after menopause.
J Jensen, C Christiansen, P Rødbro.
N Engl J Med, 1985 Oct 17; 313(16). PMID: 4047104
Highly Cited.
Elucidating prognosis and biology of breast cancer arising in young women using gene expression profiling.
Hatem A Azim, Stefan Michiels, +7 authors, Sherene Loi.
Clin Cancer Res, 2012 Jan 21; 18(5). PMID: 22261811
Highly Cited.
Impact of triple negative phenotype on breast cancer prognosis.
Henry G Kaplan, Judith A Malmgren.
Breast J, 2008 Jul 29; 14(5). PMID: 18657139
Prevalence and spectrum of p53 mutations associated with smoking in breast cancer.
Kathleen Conway, Sharon N Edmiston, +9 authors, Beth Newman.
Cancer Res, 2002 Apr 04; 62(7). PMID: 11929815
Molecular portraits of human breast tumours.
C M Perou, T Sørlie, +15 authors, D Botstein.
Nature, 2000 Aug 30; 406(6797). PMID: 10963602
Highly Cited.
Does family history influence survival in breast cancer cases?
Antonio Russo, Andrea Herd-Smith, +4 authors, Gaetano Cardona.
Int J Cancer, 2002 May 07; 99(3). PMID: 11992413
Familial breast cancer: characteristics and outcome of BRCA 1-2 positive and negative cases.
Andrea Veronesi, Clelia de Giacomi, +8 authors, Mauro Boiocchi.
BMC Cancer, 2005 Jul 06; 5. PMID: 15996267    Free PMC article.
Cigarette smoking and breast cancer risk: a long latency period?
Paul D Terry, Anthony B Miller, Thomas E Rohan.
Int J Cancer, 2002 Sep 05; 100(6). PMID: 12209614
Sociodemographic determinants of cancer treatment health literacy.
Ted Gansler, S Jane Henley, +3 authors, Edwin Slaughter.
Cancer, 2005 Jun 29; 104(3). PMID: 15983986
Gene expression profiling predicts clinical outcome of breast cancer.
Laura J van 't Veer, Hongyue Dai, +13 authors, Stephen H Friend.
Nature, 2002 Feb 02; 415(6871). PMID: 11823860
Highly Cited.
Breast cancer early detection, health beliefs, and cancer worries in randomly selected women with and without a family history of breast cancer.
Miri Cohen.
Psychooncology, 2005 Dec 24; 15(10). PMID: 16374894
Global cancer statistics, 2002.
D Max Parkin, Freddie Bray, J Ferlay, Paola Pisani.
CA Cancer J Clin, 2005 Mar 12; 55(2). PMID: 15761078
Highly Cited.
Carcinogenic and endocrine disrupting effects of cigarette smoke and risk of breast cancer.
Pierre R Band, Nhu D Le, Raymond Fang, Michèle Deschamps.
Lancet, 2002 Oct 18; 360(9339). PMID: 12383984
ABC of breast diseases. Breast cancer-epidemiology, risk factors, and genetics.
K McPherson, C M Steel, J M Dixon.
BMJ, 2000 Sep 08; 321(7261). PMID: 10977847    Free PMC article.
Highly Cited. Review.
Carcinogen-DNA adducts in human breast tissue.
F P Perera, A Estabrook, +5 authors, D H Phillips.
Cancer Epidemiol Biomarkers Prev, 1995 Apr 01; 4(3). PMID: 7606197
Breast cancer risk among women who start smoking as teenagers.
Inger T Gram, Tonje Braaten, +4 authors, Elisabete Weiderpass.
Cancer Epidemiol Biomarkers Prev, 2005 Jan 26; 14(1). PMID: 15668477
Repeated observation of breast tumor subtypes in independent gene expression data sets.
Therese Sorlie, Robert Tibshirani, +13 authors, David Botstein.
Proc Natl Acad Sci U S A, 2003 Jun 28; 100(14). PMID: 12829800    Free PMC article.
Highly Cited.
Clinical outcomes of breast cancer in carriers of BRCA1 and BRCA2 mutations.
Gad Rennert, Shantih Bisland-Naggan, +4 authors, Steven A Narod.
N Engl J Med, 2007 Jul 13; 357(2). PMID: 17625123
Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease.
Collaborative Group on Hormonal Factors in Breast Cancer.
Lancet, 2001 Nov 14; 358(9291). PMID: 11705483
Highly Cited. Review.
Family history in breast cancer is not a prognostic factor?
J J Jobsen, J H Meerwaldt, J van der Palen.
Breast, 2004 Jan 21; 9(2). PMID: 14731704
Survival in hereditary breast cancer associated with germline mutations of BRCA2.
L C Verhoog, C T Brekelmans, +10 authors, J G Klijn.
J Clin Oncol, 1999 Nov 05; 17(11). PMID: 10550133
Underlying causes of the black-white racial disparity in breast cancer mortality: a population-based analysis.
Idan Menashe, William F Anderson, Ismail Jatoi, Philip S Rosenberg.
J Natl Cancer Inst, 2009 Jul 09; 101(14). PMID: 19584327    Free PMC article.
Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer.
Cornelia Liedtke, Chafika Mazouni, +10 authors, Lajos Pusztai.
J Clin Oncol, 2008 Feb 06; 26(8). PMID: 18250347
Highly Cited.
Prepregnancy exposure to cigarette smoking and subsequent risk of postmenopausal breast cancer.
Janet E Olson, Celine M Vachon, +4 authors, Thomas A Sellers.
Mayo Clin Proc, 2005 Nov 22; 80(11). PMID: 16295021
Efficacy of neoadjuvant Cisplatin in triple-negative breast cancer.
Daniel P Silver, Andrea L Richardson, +19 authors, Judy E Garber.
J Clin Oncol, 2010 Jan 27; 28(7). PMID: 20100965    Free PMC article.
Highly Cited.
Survival of breast cancer patients in BRCA1, BRCA2, and non-BRCA1/2 breast cancer families: a relative survival analysis from Finland.
H Eerola, P Vahteristo, +6 authors, R Sankila.
Int J Cancer, 2001 Jul 04; 93(3). PMID: 11433401
Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer.
Soonmyung Paik, Gong Tang, +11 authors, Norman Wolmark.
J Clin Oncol, 2006 May 25; 24(23). PMID: 16720680
Highly Cited.
Differences in breast cancer stage, treatment, and survival by race and ethnicity.
Christopher I Li, Kathleen E Malone, Janet R Daling.
Arch Intern Med, 2003 Jan 14; 163(1). PMID: 12523916
Highly Cited.
The relation between health insurance coverage and clinical outcomes among women with breast cancer.
J Z Ayanian, B A Kohler, T Abe, A M Epstein.
N Engl J Med, 1993 Jul 29; 329(5). PMID: 8321261
Highly Cited.
Concentration of mutagens from urine by absorption with the nonpolar resin XAD-2: cigarette smokers have mutagenic urine.
E Yamasaki, B N Ames.
Proc Natl Acad Sci U S A, 1977 Aug 01; 74(8). PMID: 333441    Free PMC article.
Highly Cited.
The influence of familial and hereditary factors on the prognosis of breast cancer.
P O Chappuis, J Rosenblatt, W D Foulkes.
Ann Oncol, 1999 Dec 10; 10(10). PMID: 10586331
Review.
Efficacy of systemic adjuvant therapy for breast cancer in African-American and Caucasian women.
J J Dignam.
J Natl Cancer Inst Monogr, 2002 Jan 05; (30). PMID: 11773290
Hereditary breast and ovarian cancer: review and future perspectives.
Michael P Lux, Peter A Fasching, Matthias W Beckmann.
J Mol Med (Berl), 2005 Nov 12; 84(1). PMID: 16283147
Review.
Cigarette smoking and the risk of breast cancer in women: a review of the literature.
Paul D Terry, Thomas E Rohan.
Cancer Epidemiol Biomarkers Prev, 2002 Oct 12; 11(10 Pt 1). PMID: 12376493
Review.
Influence of young age at diagnosis and family history of breast or ovarian cancer on breast cancer outcomes in a population-based cohort study.
Jane C Figueiredo, Marguerite Ennis, +5 authors, Pamela J Goodwin.
Breast Cancer Res Treat, 2006 Nov 23; 105(1). PMID: 17115108
Estrogen and the risk of breast cancer.
M Clemons, P Goss.
N Engl J Med, 2001 Feb 15; 344(4). PMID: 11172156
Highly Cited. Review.
What is the relationship between breast cancer risk and mammography screening? A meta-analytic review.
K D McCaul, A D Branstetter, D M Schroeder, R E Glasgow.
Health Psychol, 1996 Nov 01; 15(6). PMID: 8973921
Highly Cited.
Use of statistics to assess the global burden of breast cancer.
D Maxwell Parkin, Leticia M G Fernández.
Breast J, 2006 Jan 25; 12 Suppl 1. PMID: 16430400
Review.
Breast cancer in young women: poor survival despite intensive treatment.
Hanna Fredholm, Sonja Eaker, +3 authors, Henrik Lindman.
PLoS One, 2009 Nov 13; 4(11). PMID: 19907646    Free PMC article.
Highly Cited.
Effects of smoking on serum lipoproteins and bone mineral content during postmenopausal hormone replacement therapy.
J Jensen, C Christiansen.
Am J Obstet Gynecol, 1988 Oct 01; 159(4). PMID: 2972209
Family history and the risk of breast cancer: a systematic review and meta-analysis.
P D Pharoah, N E Day, +2 authors, B A Ponder.
Int J Cancer, 1997 May 29; 71(5). PMID: 9180149
Highly Cited. Systematic Review.
The relationship between various measures of cigarette smoking and risk of breast cancer among older women 65-79 years of age (United States).
Christopher I Li, Kathleen E Malone, Janet R Daling.
Cancer Causes Control, 2005 Sep 01; 16(8). PMID: 16132806
Race, socioeconomic status, and breast cancer treatment and survival.
Cathy J Bradley, Charles W Given, Caralee Roberts.
J Natl Cancer Inst, 2002 Apr 04; 94(7). PMID: 11929949
Highly Cited.
Molecular classification of breast carcinomas using tissue microarrays.
Grace Callagy, Elena Cattaneo, +4 authors, Carlos Caldas.
Diagn Mol Pathol, 2003 Feb 27; 12(1). PMID: 12605033
Characteristics of triple-negative breast cancer.
Tim C de Ruijter, Jürgen Veeck, +2 authors, Vivianne C Tjan-Heijnen.
J Cancer Res Clin Oncol, 2010 Nov 12; 137(2). PMID: 21069385    Free PMC article.
Review.
Aromatic DNA adducts and polymorphisms of CYP1A1, NAT2, and GSTM1 in breast cancer.
Pervez F Firozi, Melissa L Bondy, +5 authors, Donghui Li.
Carcinogenesis, 2002 Mar 02; 23(2). PMID: 11872636
Family history, and impact on clinical presentation and prognosis, in a population-based breast cancer cohort from the Stockholm County.
Sara Margolin, Hemming Johansson, +2 authors, Tommy Fornander.
Fam Cancer, 2006 Jul 22; 5(4). PMID: 16858627
Impact of familial risk factors on management and survival of early-onset breast cancer: a population-based study.
H M Verkooijen, P O Chappuis, +6 authors, C Bouchardy.
Br J Cancer, 2006 Jan 13; 94(2). PMID: 16404417    Free PMC article.
Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths.
Rebecca Siegel, Elizabeth Ward, Otis Brawley, Ahmedin Jemal.
CA Cancer J Clin, 2011 Jun 21; 61(4). PMID: 21685461
Highly Cited.
Tumour characteristics, survival and prognostic factors of hereditary breast cancer from BRCA2-, BRCA1- and non-BRCA1/2 families as compared to sporadic breast cancer cases.
C T M Brekelmans, M M A Tilanus-Linthorst, +9 authors, J G M Klijn.
Eur J Cancer, 2007 Feb 20; 43(5). PMID: 17307353
Evaluation of 4-aminobiphenyl-DNA adducts in human breast cancer: the influence of tobacco smoke.
Beatrice Faraglia, Shu Yuan Chen, +9 authors, Regina M Santella.
Carcinogenesis, 2003 May 03; 24(4). PMID: 12727801
Triple-negative breast cancer: clinical features and patterns of recurrence.
Rebecca Dent, Maureen Trudeau, +7 authors, Steven A Narod.
Clin Cancer Res, 2007 Aug 03; 13(15 Pt 1). PMID: 17671126
Highly Cited.
Metabolism and activation of carcinogenic polycyclic hydrocarbons by human mammary cells.
A D MacNicoll, G C Easty, +2 authors, P Sims.
Biochem Biophys Res Commun, 1980 Aug 29; 95(4). PMID: 6774726
Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications.
T Sørlie, C M Perou, +14 authors, A L Børresen-Dale.
Proc Natl Acad Sci U S A, 2001 Sep 13; 98(19). PMID: 11553815    Free PMC article.
Highly Cited.
Cigarette smoking and urinary estrogens.
B MacMahon, D Trichopoulos, P Cole, J Brown.
N Engl J Med, 1982 Oct 21; 307(17). PMID: 7121516
Highly Cited.
Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study.
Lisa A Carey, Charles M Perou, +14 authors, Robert C Millikan.
JAMA, 2006 Jun 08; 295(21). PMID: 16757721
Highly Cited.
The "Yin and Yang" of Natural Compounds in Anticancer Therapy of Triple-Negative Breast Cancers.
Elizabeth Varghese, Samson Mathews Samuel, +3 authors, Dietrich Büsselberg.
Cancers (Basel), 2018 Sep 27; 10(10). PMID: 30248941    Free PMC article.
Review.
A Stilbenoid Isorhapontigenin as a Potential Anti-Cancer Agent against Breast Cancer through Inhibiting Sphingosine Kinases/Tubulin Stabilization.
Lalita Subedi, Mahesh Kumar Teli, +3 authors, Sun Yeou Kim.
Cancers (Basel), 2019 Dec 11; 11(12). PMID: 31817453    Free PMC article.
Delineation of the Germline and Somatic Mutation Interaction Landscape in Triple-Negative and Non-Triple-Negative Breast Cancer.
Jiande Wu, Tarun K K Mamidi, Lu Zhang, Chindo Hicks.
Int J Genomics, 2020 Jul 30; 2020. PMID: 32724790    Free PMC article.
Association between oral contraceptive use as a risk factor and triple-negative breast cancer: A systematic review and meta-analysis.
Li Li, Yahua Zhong, +5 authors, Xinying Hua.
Mol Clin Oncol, 2017 Jul 08; 7(1). PMID: 28685080    Free PMC article.
Male Breast Cancer and Hyperestrogenemia: A Thirteen-Year Review.
Khurram Bilal Tariq, Farah Al-Saffar, +4 authors, Robert Zaiden.
World J Oncol, 2014 Apr 01; 5(2). PMID: 29147378    Free PMC article.
MicroRNA-598 inhibits the growth of triple negative breast cancer cells by targeting JAG1.
Guohui Han, Xiangdong Bai, Hongchuan Jiang, Qiang He.
Exp Ther Med, 2021 Feb 20; 21(3). PMID: 33603843    Free PMC article.