| Background&objective:Breast cancer is a common malignant tumor in women.People suffere from this carcinoma rise year by year recently.and their age becomes more youthful.With the improvement of modern medical and surgical techniques.the operating therapy has becomed selected.Some studies have reported that 1t could improve survival for breast-conserving surgery plus radiotlerapy compared with lastectomy in early breast cancer.And other studies have found that molecular typing can be used as a reference index for predicting surgical procedures.However,there are no sufficient clinical data to support this view.So we need understand the importance of molecular subtype in breast-conserving surgery deeply based on a SEER database.Methods:We retrospectively analyzed 245.759 primary breast cancer patients from January 2010 to December 2013.based on the National Cancer Institute’s SEER(Surveillance,Epidemiology.and End Results)database.According to the inclusion and exclusion criteria,the 151.319 cases were included in this study finally.By using Kaplan-Meier method and Cox proportional hazards regression model,the univariate analysis was performed to investigate if different molecular subtypes were associated with overall survival(OS)in these patients.And further analyses were stratified different molecular subtvpes in breast-conserving surgery.Results:A total of 151,319 primary breast cancer were enrolled in this stud).Among the cohort,109.891 were in the HoR+/HER-2-gcroup(72.6%),16,591 were in the HoR+/HER-2+ group(11.0%).7.256 were in the HoR-/HER-2+group(4.8%).and 17,581 were in the TNBC group(11.6%).Our study showed that the disease usually begins between the ages of 30 and 59,and most were Caucasians(78.8%).According to AJCC period,there were 74,379 patients(49.2%)in the Stage Ⅰ,then the Stage Ⅱ(5 1.321 patients(33.9%)).stage Ⅲ(18,364 patients(12.1%))and stage Ⅳ(7.255 patients(4.8%)).The histological grade of HoR-/HER-2-subgroup was mainly Ⅰ、Ⅱ.and Ⅲ、Ⅳ was in the HoR+/HER-2-group.HoR-/HER-2+ group and TNBC group.Many prognostic factors were associated with molecular subtypes breast cancer.includine age.race,marital status.insurance.histological grade,surgical procedure.radiotherapy,chemotherapy and so on(all P-value<0.05).81,583 patients accepted breast-conserving surgery,the breast-conserving rates and five-year OS in four subgroups were 57.5%,44.1%,36.1%,47.9%and 81.0%.80.9%,81.5%,80.8%.Especially in the stage Ⅲ.TNBC subgroup has better prognosis undergoing breast-conserving surgery than other operations(P-value<0.05).Undergoing any operations exhibited longer five-year OS inⅣ Period(9.2%)Conclusion:Different molecular subtypes have different breast conservation rate,which the Luminal A subtype was the highest one.57.5%,and the HoR-/HER-2+ subtype was the lowest.36.1%.Additionally.All of the patients could choose to breast conservino surgery if they were feasible,because breast conserving surgery plus radiotherapy was the best prognosis unrelated to different molecular subgroups,especially TNBC subtype in Ⅲ Period.And undergoing any types of surgery in order to release the tumor load was a good prognostic factor in the Ⅳ period patients. |
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