| Background and purpose:In early breast cancer,adjuvant breast radiotherapy is an integral part of the local treatment of breast-conserving surgery to obtain local control.The incidence of breast cancer increases with age.Approximately 40% of breast cancers occur in women over the age of 65;there is evidence that for people with good baseline characteristics(especially those with small tumors,negative lymph nodes,hormone receptors)In elderly patients with early breast cancer(positive and her-2 negative),radiotherapy after breast-conserving surgery may reduce local recurrence,but it is not beneficial in terms of overall survival and disease-free survival;but it is beneficial to lymph node micrometastasis(N1mi)and N1 The benefits for patients in the early stage are unclear.This article aims to explore the impact of postoperative breast-conserving radiotherapy on the survival of N1 mi and N1 stage elderly breast cancer.Methods:Collect relevant case data from the US Surveillance Epidemiology and Final Results(SEER)database.The included population includes women 65 years and older with good clinical features who were diagnosed with T1/T2N0-1M0 breast cancer from 2010 to 2015.Exclude non-primary,recurring,bilateral and neoadjuvant cases,calculate their population baseline characteristics,clinical pathology,and survival analysis.Use SPSS23.0 statistical software to perform univariate,multivariate Cox proportional hazard regression analysis and survival analysis.The main The Observing indexes are OS and BCSS.Results:From 2010 to 2015,we identified 33,260 patients who met the research criteria,of which 24,233(72.8%)received breast-conserving postoperative radiotherapy,and9027(27.2%)did not undergo postoperative radiotherapy;population distribution As the age,the percentage of people receiving postoperative radiotherapy showed a downward trend,65-69 years old 10412(36.6%),70-74 years old,6865(26.8%)75-80 years old,4164(17.8%),80-84 years old 2044(11.2%),>85 years old 748(7.8%).Univariate Cox risk regression analysis showed the overall survival rate(hazard ratio)of the non-radiotherapy group [HR] 3.558(3.292-3.847),and 2.176(1.999-2.369)in multivariate analysis.The overall Cox risk regression analysis showed age,T2 stage(p <0.05),histological grade and N1 stage(p<0.05)are independent risk factors that affect survival;molecular classification(Luminal B)and no chemotherapy are risk factors that affect survival,but not independent risk factors;marital status,N1 mi stage is not a risk factor affecting survival;in the survival analysis,in terms of OS and BCSS,whether in the radiotherapy group or non-radiotherapy group,the population of N1 mi stage is not statistically significant compared with N0 stage,while N1 stage Compared with N0 stage,there is a significant difference in survival among the whole population;Conclusion:For elderly breast cancer patients,radiotherapy after breast-conserving surgery can achieve survival benefits;at the same time,there is no statistical difference between the survival of patients with lymph node micrometastasis and patients with stage N0;N1 stage patients compare N0 Regardless of whether radiotherapy,N1 patients have a low OS rate and BCSS rate,and there is a statistical difference p value <0.05;therefore,we believe that even elderly T1/2N1M0 breast cancer patients with good clinical features Postoperative radiotherapy is still of great significance,but for N1 mi patients,it may refer to the clinical strategy of N0 patients in terms of whether or not to undergo postoperative radiotherapy. |
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