Department of Oncology, Shengjing Hospital of China Medical University, Shenyang 110013, Liaoning, China.
Breast J. 2022 Apr 23;2022:1801717. doi: 10.1155/2022/1801717. eCollection 2022.
To explore the effect of age on the prognosis of patients with early stage breast cancer after breast-conserving surgery (BCS) and to provide references for young patients.
All clinical data of patients with early breast cancer undergoing BCS who were treated at Shengjing Hospital of China Medical University from January 2011 to May 2016 were obtained. The primary endpoints were local recurrence (LR) and distant recurrence, and the secondary endpoint was breast cancer-specific survival (BCSS). Chi-squared tests and Fisher's exact tests were used for statistical analysis. Disease-free survival (DFS) and BCSS were calculated by Kaplan-Meier survival analysis and compared using log-rank tests. Logistic regression was used for multivariable analysis of the effect of age in different subgroups. Propensity score matching (PSM) was used to reduce the bias confounding factors on oncological outcomes.
Younger patients had higher Ki-67 expression (=0.048) and larger tumors (=0.042) compared to older patients. No other clinical features were significantly different between age groups. There was no significant difference between the two groups in BCSS (=0.186); however, DFS was significantly different before PSM (=0.012). Triple-negative breast cancer and Ki-67 positivity combined with younger age at diagnosis were associated with a higher risk of recurrence (=0.018 and =0.046, respectively). After PSM, there were no significant differences in BCSS nor DFS between the two age groups (=0.559 and =0.261, respectively).
BCS for young patients is not associated with increased DFS nor BCSS. However, young patients with triple-negative breast cancer and/or Ki-67 positivity have a poor prognosis. In sum, BCS may be appropriate for a subgroup of young patients.
探讨保乳手术后（BCS）不同年龄段早期乳腺癌患者的预后差异，为年轻患者提供参考。
收集 2011 年 1 月至 2016 年 5 月在中国医科大学附属盛京医院接受 BCS 的早期乳腺癌患者的临床资料。主要终点事件为局部复发（LR）和远处复发，次要终点为乳腺癌特异性生存（BCSS）。采用卡方检验和 Fisher 确切概率法进行统计学分析。采用 Kaplan-Meier 生存分析法计算无病生存（DFS）和 BCSS，采用对数秩检验比较生存曲线。采用多因素 logistic 回归分析不同亚组中年龄的影响。采用倾向性评分匹配（PSM）降低对肿瘤学结局的偏倚混杂因素。
与年长患者相比，年轻患者的 Ki-67 表达（=0.048）和肿瘤大小（=0.042）更高。两组间其他临床特征无显著差异。两组间 BCSS 无显著差异（=0.186）；但 PSM 前 DFS 差异有统计学意义（=0.012）。三阴性乳腺癌和 Ki-67 阳性且年龄较小与复发风险增加相关（=0.018 和=0.046）。PSM 后，两组间 BCSS 或 DFS 均无显著差异（=0.559 和=0.261）。
BCS 对年轻患者并不增加 DFS 或 BCSS。但年轻的三阴性乳腺癌和/或 Ki-67 阳性患者预后较差。总体而言，BCS 可能适用于年轻患者的亚组人群。
