World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://wjon.elmerpub.com

Original Article

Volume 17, Number 2, April 2026, pages 268-276

Clinical Outcomes and Prognostic Factors in Metastatic Triple-Negative Breast Cancer: A Real-World Data Analysis

Figure 1. Flowchart of eligible patients. Patient selection criteria for the current study are shown. TNBC: triple-negative breast cancer.

Figure 2. Kaplan–Meier curves of overall survival (OS) according to the number of metastatic organs and administration of paclitaxel (PTX) and bevacizumab (BVZ). Metastatic organs were counted numerically without weighting for organ-specific prognostic impact. Group 1 (purple): solitary metastasis with PTX + BVZ (n = 15); group 2 (light purple): solitary metastasis without PTX + BVZ (n = 30); group 3 (light grey): multiple metastases with PTX + BVZ (n = 8); and group 4 (grey): multiple metastases without PTX + BVZ (n = 13).

Figure 3. Analysis of treatment lines and time to treatment discontinuation. (a) Details and comparisons of systemic drug treatments for metastatic triple-negative breast cancer are shown. “Other” includes gemcitabine (n = 7), mitomycin C plus methotrexate (n = 1), CMF (cyclophosphamide, methotrexate, and fluorouracil; n = 1), olaparib (n = 1), and trastuzumab–deruxtecan (n = 1). (b) Time to treatment discontinuation (TTD) of PTX + BVZ according to treatment line are shown. ICI: immune checkpoint inhibitor-based treatment; PTX: paclitaxel; BVZ: bevacizumab; T: taxanes; ERI: eribulin; VNR: vinorelbine; A: anthracycline; 5-FU: 5-fluorouracil.

**Table 1.** Comparisons in Clinicopathological Features Between the Treated and the Non-Treated Groups
Variables	Total (n = 96)	Treated group (n = 66)	Non-treated group (n = 30)	P value
^aAt the time of diagnosis for distant metastasis. ^bIncluding neoadjuvant chemotherapy. IDC: invasive ductal carcinoma; NST: no special type; CT: chemotherapy; DFI: disease-free interval.
Age^a (mean, year) (range)	57 (26–84)	54 (26–84)	59 (29–84)	0.068
Histology
IDC (NST)	86 (90%)	60 (90%)	26 (87%)	0.528
Others	10 (10%)	6 (10%)	4 (13%)
pT (mean, mm) (range)	36 (0–125)	37 (0–125)	34 (0–115)	0.721
pN
Positive	53 (55%)	38 (58%)	15 (50%)	0.489
Negative	43 (45%)	28 (42%)	15 (50%)
Tumor grade
High	47 (49%)	31 (47%)	16 (53%)	0.579
Low/intermediate	42 (44%)	30 (45%)	12 (40%)
Not documented	7 (7%)	5 (8%)	2 (7%)
Adjuvant CT^b
Yes	86 (90%)	60 (90%)	26 (87%)	0.528
No	10 (10%)	6 (10%)	4 (13%)
DFI (median, month) (range)	11 (0–100)	10 (0–70)	12 (1–100)	0.333
Triger for detecting mTNBC
Some symptoms	35 (36%)	17 (26%)	18 (60%)	0.005
Routine examinations	36 (38%)	29 (44%)	7 (23%)
Not documented	25 (26%)	20 (30%)	5 (17%)
Performance status
0/1	83 (86%)	66 (100%)	17 (57%)	< 0.001
2	5 (5%)	0 (0%)	5 (17%)
3/4	8 (8%)	0 (0%)	8 (27%)
Number of metastatic sites^a (mean) (range)	1.4 (1–4)	1.4 (1–4)	1.4 (1–3)	0.970
Visceral metastasis
Yes	59 (61%)	41 (62%)	18 (60%)	0.843
No	37 (39%)	25 (38%)	12 (40%)
Metastatic site
Bone	18 (19%)	15 (23%)	3 (10%)	0.139
Liver	24 (25%)	14 (21%)	10 (33%)	0.204
Lung	40 (42%)	28 (42%)	12 (40%)	0.823
Brain	15 (16%)	4 (6%)	11 (37%)	< 0.001
Others	39 (41%)	32 (48%)	7 (23%)	0.020

Table 1. Comparisons in Clinicopathological Features Between the Treated and the Non-Treated Groups

Variables

Total (n = 96)

Treated group (n = 66)

Non-treated group (n = 30)

P value

^aAt the time of diagnosis for distant metastasis. ^bIncluding neoadjuvant chemotherapy. IDC: invasive ductal carcinoma; NST: no special type; CT: chemotherapy; DFI: disease-free interval.

Age^a (mean, year) (range)

57 (26–84)

54 (26–84)

59 (29–84)

0.068

Histology

IDC (NST)

86 (90%)

60 (90%)

26 (87%)

0.528

Others

10 (10%)

6 (10%)

4 (13%)

pT (mean, mm) (range)

36 (0–125)

37 (0–125)

34 (0–115)

0.721

Positive

53 (55%)

38 (58%)

15 (50%)

0.489

Negative

43 (45%)

28 (42%)

15 (50%)

Tumor grade

High

47 (49%)

31 (47%)

16 (53%)

0.579

Low/intermediate

42 (44%)

30 (45%)

12 (40%)

Not documented

7 (7%)

5 (8%)

2 (7%)

Adjuvant CT^b

Yes

86 (90%)

60 (90%)

26 (87%)

0.528

10 (10%)

6 (10%)

4 (13%)

DFI (median, month) (range)

11 (0–100)

10 (0–70)

12 (1–100)

0.333

Triger for detecting mTNBC

Some symptoms

35 (36%)

17 (26%)

18 (60%)

0.005

Routine examinations

36 (38%)

29 (44%)

7 (23%)

Not documented

25 (26%)

20 (30%)

5 (17%)

Performance status

0/1

83 (86%)

66 (100%)

17 (57%)

< 0.001

5 (5%)

0 (0%)

5 (17%)

3/4

8 (8%)

0 (0%)

8 (27%)

Number of metastatic sites^a (mean) (range)

1.4 (1–4)

1.4 (1–3)

0.970

Visceral metastasis

Yes

59 (61%)

41 (62%)

18 (60%)

0.843

37 (39%)

25 (38%)

12 (40%)

Metastatic site

Bone

18 (19%)

15 (23%)

3 (10%)

0.139

Liver

24 (25%)

14 (21%)

10 (33%)

0.204

Lung

40 (42%)

28 (42%)

12 (40%)

0.823

Brain

15 (16%)

4 (6%)

11 (37%)

< 0.001

Others

39 (41%)

32 (48%)

7 (23%)

0.020

**Table 2.** Relationship Between Clinicopathological Features and OS (N = 66)
Variables	Univariate	Multivariate
^aAt the time of diagnosis for distant metastasis. ^bThe range odds ratio. OS: overall survival; HR: hazard ratio; CI: confidence interval; NST: no special type; CT: chemotherapy; DFI: disease-free interval; ALC: absolute lymphocyte count; NLR: neutrophil-to-lymphocyte ratio; ICI: immune checkpoint inhibitor-based treatment; PTX: paclitaxel; BVZ: bevacizumab.
Age^a	0.33^b	0.1–0.9	0.023	0.41^b	0.1–1.8	0.240
Histology, NST vs. others	0.88	0.4–2.1	0.768
High tumor grade, yes vs. no	1.68	0.9–2.9	0.062	1.03	0.5–2.0	0.925
HER2, low vs. null	0.92	0.5–1.6	0.762
Adjuvant CT, yes vs. no	1.98	0.8–4.6	0.119
DFI (months)	0.46^b	0.1–1.5	0.210	0.90^b	0.2–4.3	0.894
Number of metastatic sites^a	4.81^b	1.6–13.0	0.007	8.88^b	1.2–50.2	0.020
Visceral metastasis^a, yes vs. no	1.25	0.7–2.2	0.422
Metastatic site
Bone	1.55	0.8–2.9	0.158
Liver	1.29	0.7–2.5	0.438
Lungs	0.93	0.6–1.6	0.794
Brain	3.66	1.3–10.5	0.016	0.74	0.1–4.3	0.739
ALC^a	0.46^b	0.1–2.0	0.321
NLR^a	1.35^b	0.5–3.4	0.544	1.14^b	0.4–3.3	0.811
Administration of ICI, yes vs. no	0.70	0.3–1.8	0.444
Administration of PTX + BVZ, yes vs. no	0.54	0.3–0.9	0.028	0.44	0.2–0.9	0.029

Table 2. Relationship Between Clinicopathological Features and OS (N = 66)

Variables

Univariate

Multivariate

95% CI

P value

95% CI

P value

^aAt the time of diagnosis for distant metastasis. ^bThe range odds ratio. OS: overall survival; HR: hazard ratio; CI: confidence interval; NST: no special type; CT: chemotherapy; DFI: disease-free interval; ALC: absolute lymphocyte count; NLR: neutrophil-to-lymphocyte ratio; ICI: immune checkpoint inhibitor-based treatment; PTX: paclitaxel; BVZ: bevacizumab.

Age^a

0.33^b

0.1–0.9

0.023

0.41^b

0.1–1.8

0.240

Histology, NST vs. others

0.88

0.4–2.1

0.768

High tumor grade, yes vs. no

1.68

0.9–2.9

0.062

1.03

0.5–2.0

0.925

HER2, low vs. null

0.92

0.5–1.6

0.762

Adjuvant CT, yes vs. no

1.98

0.8–4.6

0.119

DFI (months)

0.46^b

0.1–1.5

0.210

0.90^b

0.2–4.3

0.894

Number of metastatic sites^a

4.81^b

1.6–13.0

0.007

8.88^b

1.2–50.2

0.020

Visceral metastasis^a, yes vs. no

1.25

0.7–2.2

0.422

Metastatic site

Bone

1.55

0.8–2.9

0.158

Liver

1.29

0.7–2.5

0.438

Lungs

0.93

0.6–1.6

0.794

Brain

3.66

1.3–10.5

0.016

0.74

0.1–4.3

0.739

ALC^a

0.46^b

0.1–2.0

0.321

NLR^a

1.35^b

0.5–3.4

0.544

1.14^b

0.4–3.3

0.811

Administration of ICI, yes vs. no

0.70

0.3–1.8

0.444

Administration of PTX + BVZ, yes vs. no

0.54

0.3–0.9

0.028

0.44

0.2–0.9

0.029