| Objective: Although early-stage breast cancer patients have a relatively good overall prognosis,but patients with more risk factors are prone to recurrence and metastasis.These factors may include histological grade,expression of estrogen and HER-2(human epidermal growth factor receptor2),ki-67,vascular invasion and age.Therefore,it is necessary to study these prognostic factors,and it also has certain guiding significance in choosing individualized treatment methods in clinical work at the same time.Through the analysis of 105 patients diagnosed with early-stage breast cancer in our center who were all treated with both radiotherapy and chemotherapy after breast conserving surgery(the staging of all the patients were T1-2N0-1M0),to explore the related factors affecting prognosis,and to provide some reference for clinical work.Methods: We collected and retrospectively analyzed the clinical data of 105 patients with early breast cancer who were hospitalized in the Second Affiliated Hospital of Dalian Medical University from January 2006 to December 2012,including age,menopause,tumor size,lymph node infiltration,ER(estrogen receptor)expression,PR(progesterone receptor)expression,HER-2(human epidermal growth factor receptor 2)expression,vascular cancer thrombus,NLR(Neutrophile to Lymphocyte Ratio)and operative-radiotherapy interval,and the adverse effects of radiotherapy in all patients were observed.At the same time,the counting data of the above factors were compared by chi-square test.Combined with 5-year PFS(progression-free survival)and OS(Overall Survival)status,Kaplan-Meier method was used for survival analysis,Log—rank test was used to compare the influence of these factors on survival,statistical factors were used to conduct Cox regression and multivariate analysis to find out the independent risk factors affecting the prognosis of patients with early breast cancer.Results: The median age of onset was 46 years old.The median follow-up was 77 months.5y PFS,OS were 91.4%,96.2%.All the patients were female patients after breast conserving surgery,the pathological types were mainly invasive ductal carcinoma,Grade II differentiated histological grade accounted for the majority,the pathological margin was negative,all the patients received postoperative radiotherapy combined with chemotherapy.78 cases use conventional radiotherapy and 27 cases use intensity modulated radiotherapy.The results of single factor analysis showed that the pathological type,histological grade,vascular tumor emboli,ER state,endocrine therapy are associated with patient's PFS(p<0.05).Only the vascular tumor emboli was associated with the patient's OS(P<0.05),while other factors had no significantly relations.Multiple factor analysis showed that,high histological grade and combined vascular tumor emboli could significantly influence the patient's PFS(p<0.05).Pathological type?the expression state of ER?endocrine therapy and NLR had no significant influence on the PFS(p>0.05).There were 34 cases of patients undergoing conventional radiotheraphy occurred later radiation-induced lung injury,as well as 5 cases undergoing intensity-modulated radiotherapy,with statistical difference(p< 0.05).Conclusion: 1.The overall prognosis of patients with early-stage breast cancer after breast conserving operation is relatively good,and the progression-free survival and overall survival were long.2.Histological grading,ER expression status,vascular tumor emboli,endocrine therapy and NLR were correlated with the prognosis of early-stage breast cancer patients after breast conserving surgery.3.High histological grade and the presence of vascular tumor emboli are the independent risk factor for poor prognosis in patients with early breast cancer.4.IMRT in the patients with early-stage breast cancer after breast conserving surgery is superior to 2D radiotherapy in reducing late adverse reactions to the lung,that can improve the quality of life of breast cancer patients. |
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