Frequency of Disease-Free and Overall Survival Outcomes in Triple-Negative Breast Cancer Patients Following Neoadjuvant Chemotherapy

Abstract

Background: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype with limited treatment options due to the absence of hormonal receptors. While achieving a pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) is associated with favorable outcomes, there remains a need to evaluate survival patterns and residual risk factors, particularly in low- and middle-income regions where data are scarce. Objective: This study aimed to determine the frequency of disease-free survival (DFS) and overall survival (OS) at 12 months among stage II and III TNBC patients who achieved pCR following NACT and underwent modified radical mastectomy (MRM), and to identify clinicopathological variables influencing these outcomes. Methods: A descriptive case series was conducted at INMOL Hospital, Lahore, involving 150 female TNBC patients aged 18–60 years who achieved pCR post-NACT and underwent MRM. Patients were selected based on defined clinical and pathological criteria. Data on demographic, treatment, and pathological parameters were collected, and DFS and OS at 12 months were recorded. Ethical approval was obtained in accordance with the Declaration of Helsinki. Statistical analysis was performed using SPSS version 27, applying descriptive statistics, chi-square tests, and logistic regression to evaluate associations. Results: At 12-month follow-up, DFS and OS were 88.0% and 96.0%, respectively. Surgical margin positivity was significantly associated with reduced DFS (p = 0.001), while lymph node involvement was linked with decreased OS (p = 0.015). BMI, comorbidities, and tumor size showed no significant associations with survival outcomes. Conclusion: TNBC patients achieving pCR after NACT demonstrate high short-term survival; however, surgical margin status and nodal burden remain critical prognostic factors. These findings highlight the need for meticulous surgical planning and tailored postoperative surveillance to optimize outcomes in high-risk TNBC subgroups.