Triple-Negative Breast Cancer, Recurrence, and Survival Outcomes in Young Black Women

Triple-negative breast cancer (TNBC) accounts for 40-50% of breast cancers in young Black women. Black women have an increased risk of death due to TNBC than White women; whether age contributes to worse outcomes in the setting of a high-risk tumor subtype is unclear.

Our retrospective review of an institutional database identified Black women with operable TNBC from 2005 to 2020. Clinicopathologic, treatment, and outcome variables in women aged < 40 (young adults [YAs] cohort) were compared to those ≥ 40 years using Cox proportional hazard models. Kaplan-Meier method estimated overall survival (OS) and breast cancer-specific survival (BCSS).

We identified 397 Black women with a median age of 55 (range 23-88); 39 (9.8%) were < 40 and 358 (90.2%) were ≥ 40. The YA cohort were more likely to have a BRCA mutation and present with a physical finding and more advanced clinical stage (all p < 0.01). Compared with women ≥ 40 years, those < 40 were more likely to receive mastectomy (61.5% vs. 31.3%; p < 0.001) and neoadjuvant chemotherapy (46.2% vs. 26.7%; p = 0.05), and not receive adjuvant radiotherapy (35.9% vs. 18.8%; p = 0.008). At a median follow-up of 6.2 years, the 5-year OS and BCSS rates were 81.2% and 84.0% in women < 40 years old, and 80.9% and 85.3% in those ≥ 40 (p = 0.45 and p = 0.75, respectively).

Young age at diagnosis in Black women with TNBC was not an independent predictor of locoregional recurrence, distant recurrence, OS, or BCSS despite being associated with higher stage of disease.