Differences in clinicopatholgic characteristics and risk of mortality between the triple positive and ER+/PR+/HER2− breast cancer subtypes

  • Carol A. PariseEmail author
  • Vincent Caggiano
Original Paper



This study compared the demographic and clinicopathologic characteristics and risk of mortality between the triple positive (TP) and ER+/PR+/HER2− breast cancer subtypes.


Cases of first primary female invasive TP and ER+/PR+/HER2− breast cancer were obtained from the California Cancer Registry. Logistic regression analysis was used to compare differences in factors associated with the TP versus the ER+/PR+/HER2− subtype. Cox regression was used to compute the adjusted risk of breast cancer-specific mortality of the TP versus ER+/PR+/HER2−.


The odds of TP versus ER+/PR+/HER2− were higher with advanced stage, high grade, low SES, ≤ 45 years of age (OR 1.48; CI 1.40–1.55), black (OR 1.11; CI 1.02–1.21), Asian/Pacific Islander (OR 1.15; CI 1.09–1.22), and uninsured (OR 1.42; CI 1.15–1.73). Unadjusted survival analysis indicated worse survival for the TP when compared with the ER+/PR+/HER2− subtype. However, adjusted risk of mortality for the TP subtype was not statistically significantly worse than the ER+/PR+/HER2− subtype.


Young age, advanced stage and grade, low SES, black and API race, and lack of health insurance are more common in the TP subtype than in the ER+/PR+/HER2− subtype. However the risk of mortality between these two subtypes is similar.


Breast cancer Luminal B Triple positive Mortality Risk factors Population-based registry 



We wish to thank Melissa Taylor and the staff at the Sutter Resource Library for their valuable assistance.


The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract N01-PC-35136 awarded to the Northern California Cancer Center, contract N01-PC-35139 awarded to the University of Southern California, and contract N01-PC-54404 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement 1U58DP00807-01 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the authors and endorsement by the State of California, Department of Public Health the National Cancer Institute, and the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred.

Author Contributions

CAP and VC equally contributed to the conceptualization, analysis, and writing of this manuscript.


This study was funded by Grant 947110-1107555 from the Sutter Medical Center Sacramento Foundation.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This research study involved analysis of existing data from the CCR without subject identifiers or intervention. Therefore, the study was categorized as Exempt from institutional review board oversight.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Sutter Institute for Medical ResearchSacramentoUSA

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