Liu Yaxiong, Li Honghui, Li Jinsong, Wei Changlong, Zeng Jinsheng, Tian Qiuhong
Breast Disease Center, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China.
Department of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China.
Sci Rep. 2025 Jan 17;15(1):2260. doi: 10.1038/s41598-025-85434-z.
The benefit of adjuvant chemotherapy (CT) for hormone receptor-negative T1a and T1bN0M0 breast cancer remains uncertain. Our study was to explore prognostic value and identify candidates of adjuvant CT for these patients. The data of hormone receptor-negative T1a and T1bN0M0 breast cancer patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. All patients were divided into two groups according to the history of adjuvant CT namely the CT group and the no CT (No CT) group. Univariate and multivariate Cox regression analysis were utilized to identify factors linked with cancer specific survival (CSS) and overall survival (OS) for the patients. Kaplan-Meier method was employed to determine survival benefit of adjuvant CT. A total of 3889 patients were included. After propensity score-matching, 1217 patients were assigned to the CT group and 1217 patients were assigned to the No CT group respectively. Based on multivariate Cox regression analysis of OS, older age, single, T1b stage, triple-negative tumor and absence of adjuvant CT were identified as risk factors related to OS. Besides, multivariable Cox regression analysis of CSS showed significant association between grade III+IV, T1b stage, triple-negative tumor and absence of adjuvant CT and CSS. The results from Kaplan-Meier curves revealed that adjuvant CT could bring OS benefit for these patients with more than two risk factors and could improve CSS for the patients with more than one risk factor. Our study supports the implementation of individualized strategies for hormone receptor-negative T1a and T1bN0M0 breast cancer patients. Adjuvant CT was recommended for potential beneficial patients after undertaking a risk-benefit discussion.
辅助化疗（CT）对于激素受体阴性的T1a和T1bN0M0乳腺癌患者的益处仍不确定。我们的研究旨在探索这些患者辅助CT的预后价值并确定辅助CT的适用对象。从2010年至2015年的监测、流行病学和最终结果（SEER）数据库中提取激素受体阴性的T1a和T1bN0M0乳腺癌患者的数据。所有患者根据辅助CT史分为两组，即CT组和无CT（No CT）组。采用单因素和多因素Cox回归分析来确定与患者癌症特异性生存（CSS）和总生存（OS）相关的因素。采用Kaplan-Meier法确定辅助CT的生存获益。共纳入3889例患者。经过倾向评分匹配后，分别有1217例患者被分配至CT组和1217例患者被分配至No CT组。基于OS的多因素Cox回归分析，年龄较大、单身、T1b期、三阴性肿瘤以及未进行辅助CT被确定为与OS相关的危险因素。此外，CSS的多变量Cox回归分析显示，III + IV级、T1b期、三阴性肿瘤以及未进行辅助CT与CSS之间存在显著关联。Kaplan-Meier曲线结果显示，辅助CT可为具有两个以上危险因素的患者带来OS获益，并可为具有一个以上危险因素的患者改善CSS。我们的研究支持对激素受体阴性的T1a和T1bN0M0乳腺癌患者实施个体化策略。在进行风险效益讨论后，建议对可能受益的患者进行辅助CT治疗。
