Determinants of Survival in Triple-Negative Breast Cancer: A Clinicopathological Study from Indonesian Cancer Centre

Background Triple-negative breast cancer (TNBC) poses distinct clinical challenges due to its aggressive behaviour and lack of targeted therapies. In Indonesia, socioeconomic disparities and late-stage diagnosis exacerbate poor outcomes. Objective This study investigates clinicopathological and sociodemographic factors influencing 3-year overall survival (OS) and progression-free survival (PFS) in TNBC patients in Indonesia. Methods A retrospective cohort of 290 TNBC patients diagnosed between 2015 and 2021 was analysed. Univariate and multivariate Cox regression models identified prognostic factors for OS and PFS. Kaplan-Meier curves and ROC analyses assessed model performance. Results The 3-year OS and PFS rates were 55.9% and 36.9%, respectively. Multivariate analysis revealed higher education as protective for OS (adjusted HR = 0.658, p = 0.024), while advanced stage (HR = 2.536, p < 0.001) and thrombocytosis (HR = 2.538, p < 0.001) independently predicted poor OS. Thrombocytosis (HR = 1.871, p = 0.002) and unfavourable chemotherapy response (HR = 3.369, p < 0.001) were significant predictors of reduced PFS. The predictive models showed good performance with AUCs of 0.740 (OS) and 0.733 (PFS). Conclusion TNBC survival in Indonesia is significantly shaped by both clinical and sociodemographic determinants. Thrombocytosis and residual disease post-chemotherapy are critical markers of poor prognosis, while higher education reflects better survival, likely due to increased health literacy and care access. These findings underscore the need for integrated approaches targeting early detection, inflammatory markers, and health equity to improve TNBC outcomes.