| Objective:In this study,the data of female patients with early triple-negative breast cancer from 2010 to 2015 were obtained through SEER database to explore their clinicopath-ological characteristics and analyze the effects of different surgical approaches on their prognosis,so as to provide guidance and help for clinical treatment.Methods:The SEER database population was screened through strict inclusion and exclusion criteria,and the included population was divided into BCS group,NSM group and Mastectomy group according to different surgical methods.The differences in clinicopathological characteristics of the 3 groups were compared,including age,race,marital status,lateral,histological grade,tumor size,lymph node metastasis,radiotherapy and chemotherapy,and the prognosis of the 3 groups was analyzed.Results:1.In the total population of early TNBC,6.1% were young patients(< 40 years old),80.6% were of histological grade Ⅲ,78.2 were lymph node negative(N0),and69.9% received BCS.2.The breast conserving rate of young patients was lower than that of other age groups.The breast conserving rate of < 40 years old,40-59 years old,≥60 years old patients was 62.9%,73.1%,68.0%,respectively.The breast conserving rate of Ⅱstage patients was lower than that of the stage IV(64.4% VS 79.5%),and the breast conserving rate of T2 patients was lower than that of T1(59.9% VS 77.8%).The breast retention rate of N1 patients was lower than that of N0 patients(56.6% VS73.6%).3.Cox regression competitive risk ratio model for patients with early TNBC showed that single factor showed that age,race,histological grade,stage,tumor size,lymph node status,surgical method,radiotherapy and chemotherapy were prognostic factors of early TNBC.Multiple factors showed that age,race,stage,tumor size,lymph node metastasis,surgical method and chemotherapy were the influencing factors of OS in early TNBC.Age,stage,tumor size,lymph node metastasis,surgical method and chemotherapy were the influencing factors of BCSS in early TNBC.4.A comparative analysis of the prognosis of early TNBC treated by different surgical methods showed that patients receiving BCS were more likely to receive NSM(OS: P=0.002;BCSS: P=0.001)or Mastectomy(OS: P=0.000);BCSS: P=0.000),and OS(P= 0.113)and BCSS(P=0.736)in NSM patients were similar to those in Mastecctomy.The 3-year and 5-year overall survival rates were 93.7% and 88.9% in the BCS group,83.3% and 83 in the NSM group,and 83.6% and 74.1% in the Mastectomy group,respectively.The 3-year breast cancer specific survival rates were95.1%,85.5%,89.0%,and 5-year breast cancer specific survival rates were 91.7%,85.5%,82.8%,respectively.5.In the subgroup analysis,the results showed that: except the OS(P=0.068)and BCSS(P=0.222)of the group < 40 years old who received breast-conserving therapy had no survival benefit compared with other surgical treatments,the prognosis of the other subgroups who received breast-conserving therapy was better than that of total mastectomy,which was statistically significant.In all subgroups,patients treated with NSM had comparable outcomes to those treated with Mastectomy.At the age of 40-59(OS: P=0.000;BCSS: P=0.001),Caucasians(OS: P=0.039;BCSS: P=0.008),Ⅱ phase(OS: P=0.019;BCSS: P=0.006),T2(OS: P=0.014;BCSS: P=0.001),N0(OS:P=0.004;BCSS: P=0.002),receiving chemotherapy(OS: P=0.000;BCSS: P=0.000)the prognosis of patients receiving BCS was better than that receiving NSM.Conclusion:Clinically,early TNBC is more common in middle-aged and elderly patients and has higher histological grade.Compared with NSM and Mastectomy,breastconserving combined radiotherapy was the local treatment with the greatest survival benefit for early TNBC patients.The prognosis of NSM patients is comparable to that of Mastectomy patients,and nipple-sparing Mastectomy may be a good option for women who are unable or unwilling to conserve breast. |
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