BRCAness-Driven Prognostic Model and Regimen-Specific Therapeutic Implications in Triple-Negative Breast Cancer With Residual Disease After Neoadjuvant Chemotherapy.

Authors

Hangcheng Xu, Yan Wang, Qiang Sa, Yiran Zhou, Fei Ma, Ying Fan, Pin Zhang, Qing Li, Qiao Li, Yang Luo, Ruigang Cai, Hongnan Mo, Bo Lan, Jiani Wang, Shanshan Chen, Jiayu Wang, Binghe Xu

Published in

International journal of cancer. Oct 17, 2026. Epub Oct 17, 2026.

Abstract

BRCAness, a phenotype associated with homologous recombination deficiency, has not been fully characterized in triple-negative breast cancer (TNBC) with residual disease after neoadjuvant chemotherapy (NAC), especially regarding prognosis and regimen-specific postoperative management. We analyzed 137 patients with TNBC who had residual invasive disease after NAC. BRCAness status was assessed in surgical specimens using multiplex ligation-dependent probe amplification (MLPA). Its associations with clinicopathological features and survival were evaluated according to NAC regimen, and prognostic models for disease-free survival (DFS) and overall survival (OS) were developed by combining BRCAness with clinicopathological variables. BRCAness was identified in 42.3% of tumors and was associated with high histological grade, high Ki-67, and perineural invasion. Patients with BRCAness-positive tumors had worse survival than those with BRCAness-negative tumors (5-year DFS, 50.0% vs. 68.2%, p = 0.020; 5-year OS, 58.6% vs. 78.1%, p = 0.014). This prognostic effect was evident in patients treated with anthracycline-based NAC, but not in those treated with platinum-based regimens. Models incorporating BRCAness showed good discrimination (DFS C-index, 0.70; 95% CI, 0.62-0.78; OS C-index, 0.75; 95% CI, 0.69-0.81). Among BRCAness-positive patients who had received anthracycline-based NAC, adjuvant chemotherapy was associated with better survival (5-year DFS, 55.6% vs. 27.3%, p = 0.035; 5-year OS, 66.7% vs. 36.4%, p = 0.023). BRCAness was associated with poorer outcome in residual TNBC after NAC and may help identify patients with different prognoses and postoperative treatment patterns.

PMID:
42888901
Bibliographic data and abstract were imported from PubMed on 17 Oct 2026.

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