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2026, Vol: 51, Issue: 3
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Original Research 


Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status

Hazha Abdullah Mohammed Ameen, Basak Barzngy.


Abstract
Objective: To assess the prognostic value of tumor-infiltrating lymphocytes (TILs) in triple-negative breast cancer (TNBC) by menopausal status.
Methodology: This retrospective cohort study included 442 TNBC patients treated at the University of Sulaimani from January 2015 to January 2025, including 275 premenopausal and 167 postmenopausal women. TILs were evaluated on hematoxylin and eosin-stained sections using International TILs Working Group criteria and classified as low, moderate, or high. Clinical, pathological, treatment, and survival data were analyzed using Cox regression.
Results: TIL levels were significantly associated with tumor grade (p≤0.001) but not with menopausal status. Patients with high TIL infiltration had a 63% lower risk of death than those with low or moderate infiltration (HR=0.37, HR=0.37, HR=0.37, 95% CI: 0.20–0.70, p=0.002, p=0.002, p=0.002).
Conclusion: Higher TIL levels predict better survival in TNBC regardless of menopausal status, supporting their role as a prognostic biomarker across both premenopausal and postmenopausal patients.

Key words: Triple-negative breast neoplasms, tumor-infiltrating lymphocytes, hormone negative.


 
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Pubmed Style

Ameen HAM, Barzngy B. Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status. RMJ. 2026; 51(3): 749-752. doi:10.5455/rmj.20260306084628

Web Style

Ameen HAM, Barzngy B. Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status. https://www.rmj.org.pk/?mno=312881 [Access: August 19, 2026]. doi:10.5455/rmj.20260306084628

AMA (American Medical Association) Style

Ameen HAM, Barzngy B. Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status. RMJ. 2026; 51(3): 749-752. doi:10.5455/rmj.20260306084628


Vancouver/ICMJE Style

Ameen HAM, Barzngy B. Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status. RMJ. (2026), [cited August 19, 2026]; 51(3): 749-752. doi:10.5455/rmj.20260306084628


Harvard Style

Ameen, H. A. M. & Barzngy, . B. (2026) Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status. RMJ, 51 (3), 749-752. doi:10.5455/rmj.20260306084628


Turabian Style

Ameen, Hazha Abdullah Mohammed, and Basak Barzngy. 2026. Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status. Rawal Medical Journal, 51 (3), 749-752. doi:10.5455/rmj.20260306084628


Chicago Style

Ameen, Hazha Abdullah Mohammed, and Basak Barzngy. "Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status." Rawal Medical Journal 51 (2026), 749-752. doi:10.5455/rmj.20260306084628


MLA (The Modern Language Association) Style

Ameen, Hazha Abdullah Mohammed, and Basak Barzngy. "Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status." Rawal Medical Journal 51.3 (2026), 749-752. Print. doi:10.5455/rmj.20260306084628


APA (American Psychological Association) Style

Ameen, H. A. M. & Barzngy, . B. (2026) Impact of tumor-infiltrating lymphocytes (TILs) on survival outcome in triple negative breast cancer based on menopausal status. Rawal Medical Journal, 51 (3), 749-752. doi:10.5455/rmj.20260306084628


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