Triple-negative breast cancer: Real-world evidence from a national oncologic reference center in Panama.

Abstract

e13117 Background: Triple-negative breast cancer (TNBC) accounts for 10–15% of breast cancers and is associated with aggressive behavior and limited therapeutic options. Real-world data from Latin America remain limited. Methods: We performed a retrospective observational study of patients diagnosed with TNBC and treated at Panama’s National Cancer Institute between 2019 and 2021. The protocol underwent review and approval by an institutional ethics committee. The primary endpoint was overall survival (OS), defined from histologic diagnosis to death or last follow-up. Pathologic complete response (pCR) among patients receiving neoadjuvant therapy was a secondary endpoint. Eligible patients were women ≥18 years with pathologically confirmed TNBC and no prior participation in breast cancer trials during the study period. OS was estimated using the Kaplan–Meier method, with subgroup comparisons by log-rank test. pCR was obtained from surgical pathology reports. Missing data were coded as not available. Results: Among 2,730 breast cancer diagnoses, 351 (12.8%) were TNBC. Mean age was 55.1 years. Most patients presented with symptoms (88.9%) and 59.9% had stage III–IV disease, including 25.1% with metastases. Neoadjuvant chemotherapy was administered to 59.2% of patients, with pCR achieved in 51.4% of them. Three-year OS was 89.1%, 88.6%, 67.2%, and 8.7% for stages I–IV (P < 0.05). OS varied by systemic treatment: adjuvant (84.0%), neoadjuvant (83.7%), combined therapy (70.6%), no systemic treatment (54.7%), and palliative care (17.6%) (P < 0.05). Among patients receiving neoadjuvant or combined therapy, pCR was associated with improved 3-year OS (89.4% vs 68.6%; P < 0.05). Conclusions: This large real-world cohort from a national comprehensive center highlights a high burden of TNBC in Panama. Despite aggressive biological behavior, substantial pathologic complete response rates were observed, underscoring the impact of early detection strategies, molecular classification, multimodality systemic treatment and the value of population-based registries in generating context-specific evidence for Latin America.