Retrospektive Analyse (2004 bis 2020) klinischer und histologischer Daten von Patientinnen mit Erstdiagnose und/oder Erstbehandlung eines triple-negativen Mammakarzinoms an der Klinik für Gynäkologie, gynäkologische Endokrinologie und Onkologie
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Date
2025-10-21
Authors
Publisher
Philipps-Universität Marburg
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Abstract
This study deals with the tumour biology, therapy and prognosis of triple-negative breast carcinoma, a subtype of breast cancer. Due to its clinically aggressive course and comparatively poor prognosis, there is great research interest in this tumour entity. The aim of this single-centre study is to analyse changes in the histopathological data of affected patients over time as well as differences in tumour biology and outcome within the collective. For this purpose, the data of all patients who received the initial diagnosis of ‘invasive breast cancer’ at the Department of Gynaecology, Gynaecological Endocrinology and Oncology at Marburg University Hospital from January 2004 to December 2020 were reviewed. 247 (8.7%) patients with triple-negative breast cancer were identified and subsequently analysed for the variables age at diagnosis, TNM stage, UICC stage, degree of differentiation, Ki67 score, type of chemotherapy and overall survival.
Triple-negative breast carcinomas are characterised by high TNM/UICC-stages, a low degree of differentiation and increased values of the proliferations marker Ki67, which overall indicates an aggressive tumour biology of this tumour type. This results in the often serious prognosis for patients with triple-negative breast cancer. Over the observation period, the overall survival of patients has not changed and is 70.3% after 5 years. However, the incompleteness of the follow-up data and the length of the observation period must be critically assessed. Over time, more poorly differentiated and highly proliferative tumours were observed, which indicates an increasing aggressiveness of TNBC. However, it should be noted that the determination of these pathological data is subject to subjective procedures and therefore fluctuations can occur over time. The observed increase in neo-adjuvant therapy at the Marburg site corresponds to the generally positive trend towards increased use of this form of therapy.
Young patients with unfavourable tumour biology generally receive neoadjuvant chemotherapy in line with the guidelines at the Marburg site. The lymph node status and the form of therapy were identified as prognostic factors in the multivariate analysis. Patients treated with neoadjuvant chemotherapy have a poorer prognosis compared to patients treated with adjuvant chemotherapy, although the initial presence of less favourable prognostic factors in the former must be taken into account. The prognosis is particularly unfavourable for neoadjuvant-treated patients who have not achieved complete pathological remission, which is confirmed by the results of other studies. The use of chemotherapy in general is reflected in an improved prognosis in the overall survival of patients. In Marburg, young patients with a low degree of differentiation and high Ki67 values in particular receive chemotherapy. However, the better prognosis of chemotherapy-treated patients could also be due to the age difference between the groups, as older patients tend not to receive chemotherapy but have a higher mortality risk. This also confirms the improved prognosis in premenopausal patients despite the more aggressive tumour biology compared to postmenopausal patients. The better prognosis of young patients contradicts the general study situation, which shows a poorer prognosis for this patient group. The results indicate that young patients with aggressive tumour biology are treated more successfully at the Marburg site compared to published data.
This retrospective study has identified differences in the tumour biology and prognosis of TNBC patients with different characteristics. The results provide a basis for the further development of therapeutic approaches and their adaptation in clinical practice. They can contribute to the evidence-based optimisation of the treatment of TNBC patients and lead to improved therapy results in the long term.
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Dates
Created: 2025Issued: 2025-10-21Updated: 2025-10-21
Faculty
Medizin
Language
ger
Data types
DoctoralThesis
Keywords
Triple-negative breast cancer (TNBC)Triple-negatives Mammakarzinom (TNBC)Pathological complete response (pCR)TumorbiologieTumor biologyNeoadjuvante Therapiepathologische Komplettremission (pCR)Survival analysisBreast cancerBrustkrebsÜberlebensanalyseNeoadjuvant therapy
DFG-subjects
ChemotherapieBrustkrebsSurvivalanalyseMammakarzinomHistopathologie
DDC-Numbers
610
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Schlottog, Nils: Retrospektive Analyse (2004 bis 2020) klinischer und histologischer Daten von Patientinnen mit Erstdiagnose und/oder Erstbehandlung eines triple-negativen Mammakarzinoms an der Klinik für Gynäkologie, gynäkologische Endokrinologie und Onkologie. : Philipps-Universität Marburg 2025-10-21. DOI: https://doi.org/10.17192/z2025.0541.
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This item has been published with the following license: In Copyright