| Background and Objective:In recent years,breast cancer is one of the most common malignant tumors in China,and its incidence is increasing year by year,which has a serious impact on women's life and health.The onset age of female breast cancer patients tends to be older gradually.At present,the international definition of senile breast cancer has not been unified,mainly ?65 years old and ?70 years old and so on.Chinese geriatric breast cancer experts agree that?70 years old is the age standard of senile breast cancer.Although important progress and achievements have been made in the research on the diagnosis,treatment and prognosis of female breast cancer,most clinical trials do not include the group of female breast cancer patients over 70 years old.coupled with the decline of all aspects of body function of female patients?70years old,they have poor ability to bear the treatment methods such as operation,radiotherapy and chemotherapy.The standard of treatment for the general population is not completely applicable.Based on this background,this paper makes a retrospective analysis of the clinicopathological features and prognosis of female breast cancer patients?70 years old,in order to provide a new basis for the treatmentof breast cancer in elderly women.Methods:The clinicopathological and follow-up data of 580 elderly female breast cancer patients over 70 years old treated in the affiliated Cancer Hospital of XX University from January 1,2010 to December 1,2016 were collected.All the patients in the group met the diagnostic criteria of breast cancer in the(CSCO)breast cancer guidelines of the Chinese Society of Clinical Oncology and were diagnosed as breast cancer by pathological examination.And the age of all patients was ?70 years old.Patients with poor compliance,refusing to cooperate with researchers and patients with other malignant tumors were excluded.The complete clinicopathological and medical records of the patients,such as age,complications,TNM stage,histological grade,lymph node metastasis,mode of operation,axillary lymph node operation,tumor size and treatment,were analyzed retrospectively.Regular follow-up,all patients were followed up for 5 years,and the survival time was calculated from the day of diagnosis to the time of death or December 2019.Overall survival refers to the time of death or follow-up due to any reason,and disease-free survival refers to the time that the patient relapses or dies due to cancer progression.?2test was used to infer the relationship between clinicopathological features and survival time,and Cox regression model was used to analyze the factors affecting OS and DFS.Results:The 5-year OS rate of 580 patients was 88.62%,and the 5-year DFS rate was80.69%.Single-factor analysis of 5-year survival rates for patients?70 years of age showed that patient age,TNM stage,histological grade,lymph node metastasis,PR,Ki67,and postoperative endocrine therapy were risk factors affecting 5-year OS(?~2=5.037?8.690?8.116?35.585?5.903?5.464?9.724,P<0.05).TNM staging,histological classification,axillary lymph node metastasis,ER,PR,HER-2,Ki67,postoperative chemotherapy,and endocrine therapy are risk factors that affect patients' 5-year DFS(?~2=8.250?7.185?45.808?8.820?2.667?6.084?5.622?5.584?5.419,P<0.05).There was no statistically significant association between comorbidities,tumor location,surgical approach,postoperative radiotherapy,and patient 5-year survival.(?~2=1.342and1.789?3.708and3.570?1.770and0.592 ?1.001and0.482,P>0.05);Cox regression analysis showed that patient age,TNM stage,axillary lymph node metastasis,PR,and endocrine therapy were independent prognostic factors affecting OS prognosis in elderly breast cancer patients over 70 years of age(P <0.05).Patients with TNM stage,axillary lymph node metastasis,PR,Ki67,postoperative chemotherapy,and endocrine therapy are independent prognostic factors affecting DFS in elderly breast cancer patients over 70 years of age(P <0.05)Conclusion:1?Female breast cancer patients over 70 years old's pathological type is better,the malignant degree is low,and the biological behavior is better.The positive rates of ER and PR were high,while those of triple negative breast cancer and HER-2positive were relatively low.2?The patients with early TNM stage,good histological grade and no lymph node metastasis had a good prognosis;Age was the prognostic factor of OS,there was no significant correlation between complications and prognosis.3?Endocrine therapy is a risk factor affecting OS and DFS in patients ?70 years old;Chemotherapy is a risk factor for DFS in patients ?70 years old,but has no significant effect on OS.4?The mode of operation has no significant effect on the OS and DFS of breast cancer patients?70 years old,and breast-conserving surgery is a more suitable choice for elderly patients;Staging operation of axillary lymph nodes should selectively perform sentinel lymph node biopsy or axillary lymph node dissection according to the patient's condition. |
PDF Full Text Request