title: Clinicopathological features and prognosis of triple negative breast cancer in Kuwait: A comparative/perspective analysis.
abstract: OBJECTIVE
  The aim of this study was to determine the incidence of TNBC in Kuwait, to analyze the clinicopathologic features and prognosis of this type of breast cancer, and compare it with reports from other regions of the world.
  
  
  BACKGROUND
  Triple negative breast cancer (TNBC) is defined as a subtype that is negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2). There is a growing evidence of the heterogeneity of such entity on the molecular level that may cause discrete outcomes.
  
  
  METHODS
  We analyzed the clinicopathologic features of 363 TNBC cases which were diagnosed in Kuwait from July 1999 to June 2009. The disease-free survival (DFS) and overall survival (OS) were analyzed by Kaplan-Meier method. Comparison was done with reports from USA, Europe, Middle and Far East.
  
  
  RESULTS
  Among 2986 patients diagnosed with breast cancer in Kuwait, 363 patients (12.2%) were TNBC. The median age was 48 years, 57.2% had lymph nodes (LN) metastasis, 56.9% were of grade III tumor and 41.9% had stage II disease. 81% developed recurrences and 75% of deaths occurred by 2.5 years after treatment. There is marked variation of clinicopathologic features according to country of patients' cohort.
  
  
  CONCLUSIONS
  The incidence of TNBC in our study is similar to other studies. TNBC patients showed an early major recurrence surge peaking at approximately year 2.5. Regional variation of clinicopathologic features indicates a need for molecular studies to define underlying molecular features and its impact on survival.
authors.affiliation: Radiation Oncology Department, Kuwait Cancer Control Center, Kuwait.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Fayaz
authors.affiliation: Radiation Oncology Department, Kuwait Cancer Control Center, Kuwait.
authors.forename: Mustafa S
authors.initials: MS
authors.lastname: El-Sherify
authors.affiliation: Epidemiology and Cancer Registry Department, Kuwait Cancer Control Center, Kuwait.
authors.forename: Amany
authors.initials: A
authors.lastname: El-Basmy
authors.affiliation: Radiation Oncology Department, Kuwait Cancer Control Center, Kuwait.
authors.forename: Sadeq A
authors.initials: SA
authors.lastname: Zlouf
authors.affiliation: Radiation Oncology Department, Kuwait Cancer Control Center, Kuwait.
authors.forename: Nashwa
authors.initials: N
authors.lastname: Nazmy
authors.affiliation: Radiation Oncology Department, Kuwait Cancer Control Center, Kuwait.
authors.forename: Thomas
authors.initials: T
authors.lastname: George
authors.affiliation: Radiation Oncology Department, Kuwait Cancer Control Center, Kuwait.
authors.forename: Susan
authors.initials: S
authors.lastname: Samir
authors.affiliation: Radiation Oncology Department, Kuwait Cancer Control Center, Kuwait.
authors.forename: Gerges
authors.initials: G
authors.lastname: Attia
authors.affiliation: Radiation Oncology Department, Kuwait Cancer Control Center, Kuwait.
authors.forename: Heba
authors.initials: H
authors.lastname: Eissa
keywords: Breast cancer; Clinicopathological; Epidemiology; Triple negative; Variation