The Comprehensive Breast Center, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 West 5th Road, Xi'an, 710061, China.
Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.
Sci Rep. 2024 Aug 5;14(1):18055. doi: 10.1038/s41598-024-68719-7.
The role of neoadjuvant chemotherapy and its benefits in patients with triple-negative breast cancer (TNBC) and small tumors are unclear. This study aims to compare survival differences between clinical T1 TNBC receiving neoadjuvant chemotherapy (NAC) and adjuvant chemotherapy (AC). Data for patients with clinical T1 TNBC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were categorized according to whether they received chemotherapy before or after surgery. Propensity Score Matching (PSM) was used to minimize the influence of confounding factors. OS and BCSS were compared between the two treatment sequences using Kaplan-Meier and univariate and multivariable Cox proportional hazards regression analyses. The study included 6249 women with T1 TNBC. In multivariate analysis, compared with that in the AC group, the hazard ratio for death in the NAC group was 1.54 (95% confidence interval 1.26-1.89, p < 0.001). NAC offers no additional benefits in any age group or T, N subgroups. Our findings suggest that NAC does not provide additional benefit to patients with clinical T1 TNBC, even in the presence of lymph node metastasis, or T1c.
新辅助化疗及其在三阴性乳腺癌（TNBC）和小肿瘤患者中的获益作用尚不清楚。本研究旨在比较接受新辅助化疗（NAC）和辅助化疗（AC）的临床 T1 TNBC 患者的生存差异。从监测、流行病学和最终结果（SEER）数据库中提取临床 T1 TNBC 患者的数据。根据患者是否在手术前或手术后接受化疗进行分类。采用倾向评分匹配（PSM）最小化混杂因素的影响。使用 Kaplan-Meier 法和单变量及多变量 Cox 比例风险回归分析比较两种治疗顺序的 OS 和 BCSS。该研究纳入了 6249 例 T1 TNBC 患者。多变量分析显示，与 AC 组相比，NAC 组的死亡风险比为 1.54（95%置信区间 1.26-1.89，p<0.001）。在任何年龄组或 T、N 亚组中，NAC 均未提供额外获益。我们的研究结果表明，即使存在淋巴结转移或 T1c，NAC 对临床 T1 TNBC 患者也没有额外获益。
