Clinical Significance of Tumor Grade in Triple-Negative Breast Cancer: A Retrospective Cohort Analysis

Triple-negative breast cancer (TNBC) is a heterogeneous cancer that lacks estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) proteins. Here, we investigated the prognostic value of grade in patients with TNBC. <b>Methods:</b> This re...

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Main Authors: Neya Ramanan, Mah-noor Malik, Sarang Upneja, Haniya Farooq, Swati Kulkarni, Rasna Gupta, John Mathews, Abdullah Nasser, Alina Bocicariu, Laurice Arayan, Lisa Porter, Bre-Anne Fifield, Rong Luo, Muriel Brackstone, Caroline Hamm
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/5/1100
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author Neya Ramanan
Mah-noor Malik
Sarang Upneja
Haniya Farooq
Swati Kulkarni
Rasna Gupta
John Mathews
Abdullah Nasser
Alina Bocicariu
Laurice Arayan
Lisa Porter
Bre-Anne Fifield
Rong Luo
Muriel Brackstone
Caroline Hamm
author_facet Neya Ramanan
Mah-noor Malik
Sarang Upneja
Haniya Farooq
Swati Kulkarni
Rasna Gupta
John Mathews
Abdullah Nasser
Alina Bocicariu
Laurice Arayan
Lisa Porter
Bre-Anne Fifield
Rong Luo
Muriel Brackstone
Caroline Hamm
author_sort Neya Ramanan
collection DOAJ
description Triple-negative breast cancer (TNBC) is a heterogeneous cancer that lacks estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) proteins. Here, we investigated the prognostic value of grade in patients with TNBC. <b>Methods:</b> This retrospective study analyzed 780 TNBC patients from two large regional cancer programs in Canada. Patients seen between 1 January 2004 and 31 December 2022 were included. Patients with grade 1 tumors and stage IV disease were excluded from analysis. Demographic information regarding the patient, tumor, and treatment were collected. The primary outcomes, relapse-free survival (RFS) and overall survival (OS), were analyzed using the Cox proportional hazards model and max-combo test. <b>Results:</b> For patients with grade 2 TNBC, median RFS was 14.1 years (95% CI, 9.48 to not reached (NR)) while it was not reached for patients with grade 3 tumors. No difference for relapse was identified in the first five years. Beyond 5 years, 4.9% of the patients with grade 2 tumors and 1.6% of those with grade 3 tumors relapsed (<i>p</i> = 0.006). In that same study period, 10.4% of patients with grade 2 tumors and 5.7% of those with grade 3 tumors died (<i>p</i> = 0.03). <b>Conclusion:</b> Grade 2 TNBC was associated with a higher risk of relapse and death after the 5-year mark compared to grade 3 TNBC. This distinct pattern of relapse and survival in grade 2 TNBC, characterized by an increased risk of relapse and mortality after 5 years, warrants confirmatory investigations.
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spelling doaj-art-2f80a407d4c54ec4807cc5db2b8313f62025-08-20T01:56:14ZengMDPI AGBiomedicines2227-90592025-05-01135110010.3390/biomedicines13051100Clinical Significance of Tumor Grade in Triple-Negative Breast Cancer: A Retrospective Cohort AnalysisNeya Ramanan0Mah-noor Malik1Sarang Upneja2Haniya Farooq3Swati Kulkarni4Rasna Gupta5John Mathews6Abdullah Nasser7Alina Bocicariu8Laurice Arayan9Lisa Porter10Bre-Anne Fifield11Rong Luo12Muriel Brackstone13Caroline Hamm14Schulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaSchool of Medicine, University College Dublin, D04 V1W8 Dublin, IrelandSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaDepartment of Biomedical Sciences, University of Windsor, Windsor, ON N9B 3P4, CanadaDepartment of Biomedical Sciences, University of Windsor, Windsor, ON N9B 3P4, CanadaLeddy Library, University of Windsor, Windsor, ON N9B 3P4, CanadaSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaSchulich School of Medicine and Dentistry, Western University, Windsor, ON N8W 2X3, CanadaTriple-negative breast cancer (TNBC) is a heterogeneous cancer that lacks estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) proteins. Here, we investigated the prognostic value of grade in patients with TNBC. <b>Methods:</b> This retrospective study analyzed 780 TNBC patients from two large regional cancer programs in Canada. Patients seen between 1 January 2004 and 31 December 2022 were included. Patients with grade 1 tumors and stage IV disease were excluded from analysis. Demographic information regarding the patient, tumor, and treatment were collected. The primary outcomes, relapse-free survival (RFS) and overall survival (OS), were analyzed using the Cox proportional hazards model and max-combo test. <b>Results:</b> For patients with grade 2 TNBC, median RFS was 14.1 years (95% CI, 9.48 to not reached (NR)) while it was not reached for patients with grade 3 tumors. No difference for relapse was identified in the first five years. Beyond 5 years, 4.9% of the patients with grade 2 tumors and 1.6% of those with grade 3 tumors relapsed (<i>p</i> = 0.006). In that same study period, 10.4% of patients with grade 2 tumors and 5.7% of those with grade 3 tumors died (<i>p</i> = 0.03). <b>Conclusion:</b> Grade 2 TNBC was associated with a higher risk of relapse and death after the 5-year mark compared to grade 3 TNBC. This distinct pattern of relapse and survival in grade 2 TNBC, characterized by an increased risk of relapse and mortality after 5 years, warrants confirmatory investigations.https://www.mdpi.com/2227-9059/13/5/1100breast cancertriple negativegraderelapsesurvival
spellingShingle Neya Ramanan
Mah-noor Malik
Sarang Upneja
Haniya Farooq
Swati Kulkarni
Rasna Gupta
John Mathews
Abdullah Nasser
Alina Bocicariu
Laurice Arayan
Lisa Porter
Bre-Anne Fifield
Rong Luo
Muriel Brackstone
Caroline Hamm
Clinical Significance of Tumor Grade in Triple-Negative Breast Cancer: A Retrospective Cohort Analysis
Biomedicines
breast cancer
triple negative
grade
relapse
survival
title Clinical Significance of Tumor Grade in Triple-Negative Breast Cancer: A Retrospective Cohort Analysis
title_full Clinical Significance of Tumor Grade in Triple-Negative Breast Cancer: A Retrospective Cohort Analysis
title_fullStr Clinical Significance of Tumor Grade in Triple-Negative Breast Cancer: A Retrospective Cohort Analysis
title_full_unstemmed Clinical Significance of Tumor Grade in Triple-Negative Breast Cancer: A Retrospective Cohort Analysis
title_short Clinical Significance of Tumor Grade in Triple-Negative Breast Cancer: A Retrospective Cohort Analysis
title_sort clinical significance of tumor grade in triple negative breast cancer a retrospective cohort analysis
topic breast cancer
triple negative
grade
relapse
survival
url https://www.mdpi.com/2227-9059/13/5/1100
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