Living With Triple-Negative Breast Cancer in Portugal: More Debilitating or Lethal?

OBJECTIVES: Breast cancer (BC) is the 2^nd neoplasm with the highest incidence globally (47,8 new cases/100 000), corresponding to a total of 2 261 419 new cases. It is the leading cause of death from cancer in females (13,6 deaths/100 000). Triple-negative breast cancer (TNBC) is reported to be associated with lower survival and higher incidence rates of early recurrences among younger women, comparing to other types of BC. In this study, we aimed to determine the clinical and humanistic burden of TNBC in female population in Portugal in 2019, from a societal perspective.

METHODS: The burden of disease was expressed using disability-adjusted life years (DALY). TNBC’s prevalence was calculated using a cumulative incidence model, based on national epidemiological data.

RESULTS: Considering a total of 1 272 new cases and 676 deaths from TNBC, the humanistic burden was estimated to be 22 566 DALY/year. Deaths resulted in 21 266 years of life lost (YLL), especially among women aged between 45-49, whereas the value of years lived with disability (YLD) was found to be 1 300, clearly depicting its lethal feature. Stage IV was the main contributor for both components, being associated with 15 063 YLL and 733 YLD.

CONCLUSIONS: Although it only represents 15% of newly diagnosed with BC, almost half of humanistic burden of BC (46%) is attributable to TNBC subtype (22 566 DALY/year). The total value of YLL far outweighed the YLD in TNBC among female patients (21 266 YLL vs. 1 300 YLD), meaning that this BC subtype is particularly deadly. These findings suggest that adopting more effective disease management strategies and health policies, particularly in earlier stages, can potentially reduce the real burden of TNBC to society and Portuguese healthcare system.