Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin, China.
Front Public Health. 2023 Feb 21;11:1100421. doi: 10.3389/fpubh.2023.1100421. eCollection 2023.
The relationship between age and the outcome of breast cancer neoadjuvant chemotherapy (NAC) remains controversial, and little is known about the choice of surgical treatment for young patients. In this multicenter real-world study, we sought to analyze the outcome of NAC as well as the current status and trend of surgical decision-making after NAC in young breast cancer patients.
The medical records of patients from 20 hospitals in different regions of China were collected retrospectively. The study population included females diagnosed with cT1-4N0-3M0 breast cancer who received NAC from January 2010 to December 2020.
A total of 9,643 eligible patients were included, 1,945 (20.2%) of whom were ≤40 years old. Young patients tend to have a higher tumor stage and a higher proportion of Luminal B and triple-negative breast cancer (TNBC) tumors compared with the >40-year-old group. The breast pathological complete response (pCR) rate in the young group was 20.3%, and Luminal B tumor was more likely to obtain pCR in young patients. The implementation rate of breast-conserving surgery (BCS) and breast reconstruction surgery was higher in young patients and tended to increase over time. In different regions of China, there were great differences in the choice of surgical treatment after NAC among young patients.
Breast cancer in young women has unique clinical characteristics, but age does not affect the overall pCR rate. In China, the BCS rate after NAC is increasing over time but is still at a low level.
年龄与乳腺癌新辅助化疗（NAC）结局之间的关系仍存在争议，对于年轻患者的手术治疗选择知之甚少。在这项多中心真实世界研究中，我们旨在分析年轻乳腺癌患者 NAC 的结局以及 NAC 后手术决策的现状和趋势。
回顾性收集了来自中国不同地区 20 家医院的患者病历。研究人群包括接受 NAC 的女性 cT1-4N0-3M0 乳腺癌患者，NAC 时间为 2010 年 1 月至 2020 年 12 月。
共纳入 9643 例符合条件的患者，其中≤40 岁的患者有 1945 例（20.2%）。年轻患者的肿瘤分期较高，Luminal B 型和三阴性乳腺癌（TNBC）肿瘤的比例较高。年轻组的乳腺病理完全缓解（pCR）率为 20.3%，Luminal B 型肿瘤在年轻患者中更可能获得 pCR。年轻患者保乳手术（BCS）和乳房重建手术的实施率较高，且呈逐年上升趋势。在中国不同地区，年轻患者 NAC 后手术治疗的选择存在较大差异。
年轻女性的乳腺癌具有独特的临床特征，但年龄并不影响总体 pCR 率。在中国，NAC 后 BCS 率呈上升趋势，但仍处于较低水平。
