| Objective: Exploring the potential risk factors that affect the prognosis of T1 HER-2positive early breast cancer and the effect of trastuzumab on the prognosis,and construct a nomogram as a personalized risk prediction tool.Methods: The study included patients with p T1 stage HER-2 positive early breast cancer who underwent surgery at the Cancer Hospital of Xinjiang Medical University from January 1,2010 to June 30,2019,and were collected by consulting the patient’s outpatient clinic,hospital follow-up visit records,and telephone follow-up for Survival data.Cox multivariate analysis was used to determine potential risk factors,and a nomogram was constructed based on Cox regression results and combined with clinically selected prognostic factors.C-index and calibration chart were used to verify the discriminative ability and accuracy of nomogram to predict 3-year and 5-year DFS,and Kaplan-Meier method was used to draw survival curve and subgroup analysis.Result: The study included a total of 618 patients with HER-2 positive early breast cancer after T1 surgery.The median age of the patients was 50 years old,the median follow-up was 48(5-120)months,315 patients(51.0%)received postoperative trastuzumab treatment,and 74 patients(12%)experienced recurrence,metastasis or death.The 5-year DFS and OS in the trastuzumab treatment group were 89.2% and 94.8%,respectively,without trastuzumab treatment The 5-year DFS and OS of the group were85.4% and 90.5%,respectively.Histological grade,axillary lymph node metastasis,menopause,Ki-67 and chemotherapy were found to be potential factors affecting the prognosis.Conclusion: Postoperative adjuvant trastuzumab therapy can improve the prognosis of patients with T1 HER2-positive early breast cancer.The nomogram we constructed can accurately predict the 3-year and 5-year disease-free survival of patients with T1 HER2-positive early breast cancer.But more external verification is still needed. |
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