Locoregional recurrence in triple negative breast cancer: past, present, and future

Expert Rev Anticancer Ther. 2023 Jul-Dec;23(10):1085-1093. doi: 10.1080/14737140.2023.2262760. Epub 2023 Oct 26.

Abstract

Introduction: Triple negative breast cancer (TNBC) is a rare but aggressive biological subtype of breast cancer associated with higher locoregional and distant recurrence rates and lower overall survival despite advancements in diagnostic and treatment strategies.

Areas covered: This review explores the evolving landscape of locoregional recurrence (LRR) in TNBC with improved surgical and radiation therapy delivery techniques including salvage breast conserving surgery (SBCS), re-irradiation, and thermo-radiation. We review current retrospective and prospective, albeit limited, clinical data highlighting the optimal management of locoregionally recurrent TNBC. We also discuss tumor genomic profiling and transcriptome analysis and review potential investigational directions.

Expert opinion: Significant progress has been made in the prevention of LRR but rates remain suboptimal, particularly in the TNBC population, and outcomes following LRR are poor. Further prospective studies are needed to identify the most effective and safest systemic therapy regimens and to whom it should be offered. There has been growing interest in the role of molecular markers, genomic signatures, and tumor microenvironment in predicting outcomes and guiding LRR treatment. Transcriptome analyses and biomarker-driven investigations are currently being studied and represent a promising era of development in the management of LRR.

Keywords: Local recurrence; locoregional recurrence; regional recurrence; transcriptome analysis; triple negative breast cancer.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms* / pathology
  • Female
  • Humans
  • Mastectomy, Segmental
  • Neoplasm Recurrence, Local / pathology
  • Prospective Studies
  • Retrospective Studies
  • Triple Negative Breast Neoplasms* / genetics
  • Triple Negative Breast Neoplasms* / therapy
  • Tumor Microenvironment