Clinical Study And Prognosis Of The Different Adjuvant Chemotherapy Options In The Axillary Lymph Node-negative Breast Cancer

Background Breast cancer is one of the common female malignancy,mortality arrangesecond seat,lung cancer is the first.Major adjuvant treatment of postoperative of breastcancer is chemotherapy. axillary lymph node-negative breast cancer patients have goodprognosis in Initial treatment, treatment programs base on anthracycline-based inpostoperative adjuvant chemotherapy regimens: epirubicin combine with fluorouracil andcyclophosphamide (CEF)epirubicin combine with docetaxel and cyclophosphamide (TEC)and epirubicin combined with docetaxel (TE). price of the paclitaxel drug is expensive inthe current market therefore, how to choose the axillary lymph node-negative breast canceradjuvant chemotherapy to improve the efficacy,mitigate toxicity of chemotherapy andeconomic burden of patients is the focus of today research,also will conduce to chooseindividualized treatment options of breast cancer.Objective To analyze480cases of axillary lymph node-negative breast cancer patientsrespectively utilize CEF (fluorouracil+epirubicin+cyclophosphamide), TEC(docetaxel+epirubicin+cyclophosphamide) and TE (docetaxel+epirubicin) three differentchemotherapy regimens for adjuvant chemotherapy.Observed three programs efficacyand toxicity,and to explore more effective chemotherapy.Methods The date of480patients with axillary lymph node-negative breast cancer of theclinical was retrospectively analyzed.These patients respectively utilize CEF,TEC and TEthree different chemotherapy regimens for adjuvant chemotherapy from march2003to march2007in Breast Surgery of First Affiliated Hospital of Anhui Medical University,All Patients were confirmed by surgery for invasive breast cancer in female patients, aged29to77years old, with a median age of53years old. Pathological types are infiltratingductal breast cancer,WHO I grade have80cases, WHO II grade have330cases, WHO IIIgrade have70cases. Axillary lymph node-negative mean no cancer metastasis byhistological examination and axillary lymph number is greater than10. All patients in ourhospital to undergo surgery and a full course of chemotherapy, Karnofsky score is morethan90points. Check blood, liver and kidney function, electrolytes, glucose, ECG werenormal before chemotherapy, had no chemotherapy prohibition.Divided into CEF group,TEC group TE group. Less than35-year-old group and more than35-year-old; dividedinto four groups on the basis of molecular subtypes: Luminal A type group, Luminal B typegroup, Her-2overexpression group, triple negative group; To bserved Toxicity,five-yeardisease-free survival (DFS) and overall survival rate (OS) in each group.Results All patients appear drug toxicity, The digestive toxicity probability respectivewere50%,75%,69%in the CEF group,TEC group and the TE group,three groups showedno statistically significant; three groups of the hematologic toxicity probability respectivewere25%,62%,59%(P<0.05); probability of skin and mucosal injury were13%,28%,25%(P <0.05); nervous system toxicity probability were3%,6%,6%, the three groups wasnot statistically significant; probability of cardiotoxicity were38%,63%,62%(P <0.05);probability of reproductive system toxicity were3%,5%,5%, and the three groups was notstatistically significant. the median survival time were49.6,50.8,51.1month in the CEFgroup,TEC group and the TE group. The five-year DFS and OS in the three groups ofpatients was not statistically significant, the three groups of patients disease-free survivalcurves and overall survival curves showed no statistically significant. three groups ofpatients with Her-2+type DFS, OS difference was statistically significant (P<0.05), and thethe Luminal A group with Her-2+group of difference was statistically significant (P <0.05).Have no statistically significant in5-year DFS and OS in the other groups. Conclusions Adjuvant chemotherapy in low-risk breast cancer patients with axillarylymph node-negative, the CEF program and TEC programs and TE program all have idealfive-year DFS and OS.Therefore Containing paclitaxel program have no advantage,andincrease chemotherapy toxicity and the patient’s financial burden.For high-risk patientsshould be recommended to choose containing paclitaxel and anthracycline chemotherapy,which can improve long-term survival.