Investigation of prognostic factors in triple-negative breast cancer patients receiving neoadjuvant chemotherapy

Introduction and Objective: Breast cancer is one of the most common types of cancer, characterized by uncontrolled proliferation of lobular and ductal cells in the breast, and is predominantly observed in women. This type of cancer holds a significant place among global health concerns and is classified into different biological subtypes, including hormone receptor-positive, HER2-positive, and triple-negative breast cancer (TNBC). TNBC is an aggressive subtype that lacks estrogen, progesterone, and HER2 receptors, making it unresponsive to existing hormonal and targeted therapies. This study aims to evaluate the effectiveness of neoadjuvant chemotherapy in patients diagnosed with TNBC and to assess the impact of various prognostic factors on disease outcomes. Materials and Methods: A total of 73 patients aged 18 years and older, diagnosed with triple-negative breast cancer and treated with neoadjuvant chemotherapy between 2018 and 2023 at the Pamukkale University Medical Oncology Department, were included in this study. Clinical and laboratory data of the patients were retrospectively recorded from patient files and the hospital information system. The relationships between demographic characteristics, laboratory parameters, clinical status, prognostic markers, and survival outcomes were analyzed. Results: Patients with stage 1 and 2 TNBC had higher overall survival (OS) and progression-free survival (PFS) rates compared to those with stage 3 disease. Patients who did not receive neoadjuvant chemotherapy also demonstrated higher OS and PFS rates. Among different histological subtypes, patients with invasive ductal carcinoma had better OS rates than those with other histological subtypes. Additionally, patients with a lower neutrophil-to-lymphocyte ratio (NLR) had significantly higher OS and PFS rates compared to those with a higher NLR. In our study, no statistically significant relationship was found between OS and PFS and factors such as age, smoking, alcohol consumption, menopause status, tumor lateralization, tumor grade, Ki-67 index, and adjuvant chemotherapy. Conclusion: Among the TNBC patients included in this study, stage, neoadjuvant chemotherapy status, histological subtype in surgical pathology, and neutrophil-to- lymphocyte ratio (NLR) were found to be statistically significant factors associated with survival rates. However, the number of patients evaluated in our study does not constitute a large sample size. Further studies are needed to clarify the reasons for the varying results found in the literature. Keywords: Breast Cancer; Triple Breast Cancer; Neoadjuvant Chemotherapy; Prognostic Factor