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新辅助化疗对 T1N0M0 三阴性和 HER-2 阳性乳腺癌患者的影响:基于 SEER 数据库的回顾性分析。

The Impact of Neoadjuvant Chemotherapy on Patients With T1N0M0 Triple-Negative and HER-2 Positive Breast Cancer: A Retrospective Analysis Based on the SEER Database.

机构信息

Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

出版信息

Clin Breast Cancer. 2024 Oct;24(7):e593-e599. doi: 10.1016/j.clbc.2024.05.011. Epub 2024 May 31.

Abstract

BACKGROUND

The utilization of neoadjuvant chemotherapy (NAC) originated in the treatment of locally advanced breast cancer (BC). Our study is designed to elucidate the effects of NAC on patients with T1N0M0 triple-negative and HER-2 positive BC.

METHODS

This study involved the selection of 10,614 patients diagnosed with T1N0M0 triple-negative and HER-2 positive breast cancer (BC) from the surveillance, epidemiology, and end results (SEER) database. To ascertain the impact of neoadjuvant chemotherapy (NAC) on T1a, T1b, and T1c N0M0 BC, we conducted multivariate Cox regression analyses. Similarly, we performed multivariate Cox regression analyses to compare the effects of neoadjuvant chemotherapy against adjuvant chemotherapy on T1N0M0 BC. The Kaplan-Meier method was employed to delineate survival curves for different molecular subtypes and clinical stages.

RESULTS

The data results from the SEER database reveal a significant enhancement of overall survival (OS) in T1c BC patients as a result of NAC. For T1b BC patients, NAC does not present any significant effect. Contrarily, NAC seems to adversely impact the OS of T1a triple-negative BC patients. However, the prognosis comparison between neoadjuvant and adjuvant chemotherapy for T1N0M0 breast cancer did not show any significant difference, with the exception of T1a triple-negative BC.

CONCLUSIONS

Patients with T1cN0M0 triple-negative and HER-2 positive BC may derive OS benefits from NAC. Additionally, NAC could be detrimental to T1a triple-negative BC.

摘要

背景

新辅助化疗(NAC)最初用于治疗局部晚期乳腺癌(BC)。我们的研究旨在阐明 NAC 对 T1N0M0 三阴性和 HER-2 阳性 BC 患者的影响。

方法

本研究从监测、流行病学和最终结果(SEER)数据库中选择了 10614 例 T1N0M0 三阴性和 HER-2 阳性乳腺癌(BC)患者。为了确定新辅助化疗(NAC)对 T1a、T1b 和 T1c N0M0 BC 的影响,我们进行了多变量 Cox 回归分析。同样,我们进行了多变量 Cox 回归分析,比较了 NAC 对 T1N0M0 BC 的疗效与辅助化疗的疗效。Kaplan-Meier 法用于描绘不同分子亚型和临床分期的生存曲线。

结果

SEER 数据库的数据结果显示,NAC 显著提高了 T1c BC 患者的总生存率(OS)。对于 T1b BC 患者,NAC 没有显著效果。相反,NAC 似乎对 T1a 三阴性 BC 患者的 OS 产生不利影响。然而,T1N0M0 乳腺癌新辅助化疗与辅助化疗的预后比较除 T1a 三阴性 BC 外,无显著差异。

结论

T1cN0M0 三阴性和 HER-2 阳性 BC 患者可能从 NAC 中获益 OS。此外,NAC 可能对 T1a 三阴性 BC 有害。

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