Analysis Of Postoperative Prognostic Factors Of Elderly Patients With Triple-negative Breast Cancer

Objective: Triple-negative breast cancer is one of the subtypes of breast cancer with relatively poor prognosis,and its diagnosis,treatment,prognosis and other issues have been the focus and hotspot of related research in recent years.Among patients with triple-negative breast cancer,older patients have always been considered to have a better prognosis than younger patients,including a relatively low recurrence and metastasis rate,and a higher five-year survival rate.The purpose of this research is to analyze the clinicopathologic features of elderly patients with triple-negative breast cancer(TNBC)and explore the influencing factors of postoperative prognosis.Methods: The TNBC patients who were pathologically confirmed in the Affiliated Hospital of Southwest Medical University from January 1st,2013 to January 1st,2014 were retrospectively collected.The differences of clinicopathologic characteristics bwteeen elderly and young and middle-aged patients(according to the standard of 65 years old)were analyzed.The χ2 test was used to analyze the clinical pathological characteristics of the two groups of patients,such as family history and axillary lymph node status,and the rank sum test was used to analyze and compare the clinical stage and histological grading of the two groups.The Cox risk regression model was used to analyze the prognosis of elderly TNBC patients Influencing factors;survival analysis was tested by log-rank method.Results: A total of 142 patients with TNBC were collected,including 53 elderly patients and 89 young and middle-aged patients.There were no significant differences in terms of family history,histological grade,clinical stage,tumor T stage,axillary lymph node status,and chemotherapy between the elderly patients and young and middle-aged patients(P>0.05).Compared with young and middle-aged patients,elderly patients have a lower Ki-67 index(≤30%,,χ2=3.712,P=0.043).The rate of breast conserving surgery in the young and middle-aged patients was higher than that in the elderly patients(χ2=4.665,P=0.031).All patients were followed up to 60 months,the recurrence and metastasis rate and the mortality of the elderly patients were lower than those of the young and middle-aged patients(recurrence and metastasis rate:30.2% versus.47.2%,χ2=3.974,P=0.046;mortality: 11.3% versus 28.1%,χ2=5.474,P=0.019),and the disease-free survival rate and overall survival rate of the elderly patients were higher than those of the young and middle-aged patients(disease-free survival rate: 69.8% versus 52.8%,χ2=4.106,P=0.037;overall survival rate: 88.7% versus 71.9%,χ2=5.209,P=0.022).The tumor size(χ2=14.806,P=0.001)and number of axillary lymph node metastases(χ2=8.149,P=0.043)were associated with postoperative recurrence and metastasis in the elderly patients with TNBC by univariate analysis,and which were the independent risk factors for the recurrence and metastasis in the elderly patients with TNBC.Conclusion: Elderly TNBC patients have a better prognosis than middle-aged and young patients,which is specifically characterized by a higher5-year disease-free survival rate and 5-year overall survival rate.Tumor size and axillary lymph node status are independent risk factors that affect their prognosis.The larger the tumor at the first treatment and more metastatic axillary lymph nodes,the worse the prognosis.