Clinicopathological Characteristics And Prognosis In Different Age Breast Cancer Patients Treated With Breast Conserving Surgery

Objective To analyze the clinical and pathological features and prognosis of breast-conserving surgery in different age patients with breast cancer.Methods The clinical data of 254 breast cancer patients undergoing breast-conserving surgery from January 2010 to January 2016 in Guangxi medical university affiliated cancer hospital were retrospectively analyzed.The patients were divided into 3 groups according to different age groups.The youth group: age ? 35 years old,middle age group: 35 years old <age ? 60 years old group: age> 60 years old.The clinical pathological characteristics,no local recurrence,survival rate,no distant metastasis survival and overall survival were analyzed and compared.Multiariable COX analysis were used to analyze whether age is the independent factor affecting prognosis.Results Among the 254 patients,41 were young(16.14%),198 were middle-aged(77.95%),while those in the elderly were 15(5.91%).The youth group had 100% nonmenopause,74.24% in the middle-aged group,and 0% in the elderly group.The positive rate of estrogen receptors in the youth and middle-aged groups was 65.85% and 55.56%,respectively,which was lowerthan the 86.67% in the elderly group.The rate of chemotherapy was 95.12% in young group,88.89% in middle-aged group and 33.33% in old group,the difference was statistically significant(P <0.05).There was no significant difference in tumor size,TNM staging,lymph node positive rate,histological grade,PR status,HER-2 status,endocrine therapy,and radiotherapy between the groups(P>0.05).The 5-years non-local recurrence survival rates of the young,middle,and elderly patients were 87.2%,90.7%,and 92.9%,respectively;there was no statistically significant difference(P>0.05);The 5-years metastasis-free survival rate of the youth,middle-aged,and elderly patients were 86.1%,85.3%,and 92.3%,the difference was not statistically significant(P>0.05).The 5-years overall survival rate of the young,middle,and elderly patients were 90.7%,91.5%,and 92.3%,the difference was not statistically significant(P> 0.05).Multivariate COX analysis showed that: The risk of local recurrence was significantly lower in the elderly group than in the middle-aged group(HR=0.22,P=0.020);the older the age of breast-conserving surgery,the lower the risk of local recurrence,but it is not significant from the point of view of no distant metastasis survival rate and overall survival rate(P>0.05),so breast-conserving surgery is still relatively safe in young and middle-aged patients;radiotherapy after breast-conserving surgery can reduce the risk of local recurrence(HR=0.18,P=0.011),but there was no significant correlation between metastasis-free survival rate and overall survival(P>0.05);chemotherapy after breast-conserving surgery can improve overall survival(HR=0.01,P=0.016),there was no significant correlation between distant metastasis-free survival and overall survival(P>0.05);no significant statistical significance was found in regression analysis of other factors.Conclusion The estrogen receptor positive rate of young and middle-agedwomen is lower than that of elderly women;Regular radiotherapy after breast conserving surgery can reduce the risk of local recurrence,postoperative breast-conserving chemotherapy can improve overall survival.After comprehensive treatment,the local recurrence,distant metastasis,and death rate of young and middle-aged breast-conserving surgery patients were not significantly different from those of elderly patients with breast-conserving surgery.