A Retrospective Prognostic Analysis Of367Early-stage Breast Cancer Patients With Breast-conserving Treatment

Objective: This article based on a retrospective analysis for367cases ofearly-stage and part of the clinical data of patients with III-stage breast cancer fromJanuary1,2002to31October2011in the first hospital of Jilin University whoreceived breast-conversing surgery.And discussing the indications, contraindications,comprehensive treatment of the postoperative condition and risk factors affecting theprognosis the breast surgery in our country.Methods: The data of367early-stage and part of the clinical data of patientswith III-stage breast cancer patients, who received BCT in Jilin University firsthospital from January1st,2002to October31st,2011,were collected and analyzedretrospectively. All the patients received extensive lumpectomy resection.298cases ofpatients had recieved axillary lymph node dissection,69patients received sentinellymph node biopsy. According to TNM stage and the postoperative pathologic results,the patients had a choice to decide whether or not to receiving chemotherapy,radiotherapy and endocrine therapy. By using SPSS18.0statistical software toanalyze the relationship between the Single factor variables and prognosis with thelog-rank test, the single factor included⑴age⑵family history⑶menstruation⑷Tumor size⑸Lymph node metastasis⑹molecular subtype⑺ER status⑻Radiotherapy⑼chemotherapy⑽endocrinotherapy⑾neoadjuvant chemotherapy.Through Cox regression test analyzed the multiple factors. To Compare the overallsurvival (OS) and disease-free survival (DFS), at the same time evaluate thesatisfaction of postoperative breast shape beauty effect.Results: The median time of follow-up was35months and the mean time was40months.16cases died;3cases got local recurrences and23cases had distantmetastases. As to the location of metastasis,3cases were found in lungs、2cases inlivers、2case in brain and6cases in bones.1case was in both brain and lung and5cases were in more than3locations at the same time. The5-years overall survival rate was91.5%and the disease-free survival rate was87.7%. Log-rank methodshowed the3groups of lymph node status（transfer of0,1-3,4or more）of overallsurvival and disease-free survival have statistically significant differences（p=0.0、p=0.0）;2groups of ER (positive/negative) and3groups of molecular subtype(luminal type、Her-2expression type、triple-negative type) of disease-free survivalhave statistically significant differences(p=0.018、p=0.011).Single factor analysisshowed that the size of tumor (>3cm), lymph node staging (N2, N3) and ER(negative), PR (negative), Her-2(positive) as the risk factors of local recurrence. Thesingle factor analysis that related to survival and the multifactor analysis resultsshowed that the lymph node staging (N2, N3) and Her-2(positive) are the riskfactors of local recurrence and survival. According to the JCRT simple criteriaevaluating the cosmetic effect, the satisfaction rate of all the survival patients was95.3%（323/339）。Conclusion: Breast surgery treatment must conform the indications strictly. itsOS and DFS are the same as the traditional modified radical operation. Cosmeticeffect is satisfactory and at the same time, BCT is able to improve the patient’s lifequality substantially. Comprehensive treatment is the key to the success ofbreast-conversing treatment and we should attach importance to the cooperationamong multidisciplinary collaboration.We should enhance the patients who receivedthe BCT having good adherence.