| Objective:The current classification of breast cancer mainly includes type luminal A,luminal B,Her2 over expression and Triple Negative Breast Cancer.Triple Negative Breast Cancer is a type of breast cancer that is negative for estrogen receptor(ER),progesterone receptor(PR)and Human epidermal growth factor receptor-2(Her-2).Because Triple Negative Breast Cancer is not sensitive to endocrine therapy and molecular targeted therapy,chemotherapy is the main systemic treatment.The research time to start of adjuvant chemotherapy after curative surgery influences survival in early stage Triple Negative Breast Cancer and the prognosis relevance influence,Better obtains benefits from the adjuvant chemotherapy.Methods:Collect medical records of patients diagnosed with breast cancer concurrent breast by modified radical mastectomy at the Breast Center of the Hospital of Qingdao University from 2010 to 2013.Women who have had a history of breast related disease,or have a history of breast tumor resection or breast reconstruction,have been treated with neoadjuvant chemotherapy or other preoperative treatment,and women who are pregnant or lactation are excluded.303 patients with Triple negative breast cancer in stage I to III were selected for retrospective study.The disease-free survival(DFS)and overall survival(OS)were compared among patients grouped by time from definitive curative surgery to start of adjuvant chemotherapy.According to the starting time of postoperative chemotherapy,they were divided into 4 groups,which were within 14 days,15 days to 28 days,29 days to 42 days,and more than 42 days.From December 2016 to January 2018,111 cases recurred,86 patients died and 0 cases were lost.Results:The 5-year DFS for each group was 60.0%,72.2%,65.0%,and 51.3%,respectively.The 5-year OS for each group was 72.0%,82.2%,71.2%,and 56.8%,respectively.The total five-year DFS of TNBC was 63%,and the 5-year overall survival rate was 71.6%.The test P=0.025(P<0.05)of 4 sets of data DFS was of statistical significance.Further comparison results show.The DFS in group 2 was significantly greater than that in group4,P=0.003(P<0.05),and there was no significant difference between the other two(P>0.05).This suggested that the DFS could be significantly increased from 14 to 28 days after surgery compared with those in the group greater than 42 days.The same is true for the OS statistics,The OS of the 4 groups had significant difference P=0.004(P<0.05),and the OS of the second groups was significantly greater than that of the fourth groups(P< 0.001).It was suggested that the chemotherapy OS increased significantly at the 15-28 day after the operation than the 42 day group.Conclusion:1.The starting time of postoperative adjuvant chemotherapy was 14 days,15-28 days,29-42 days and 42 days,and their DFS difference was statistically significant.In this study,the 15-28 day group had the highest disease-free survival and median disease-free survival time.2.From the results of multiple comparisons,DFS in 15-28 days is better than that in42 days.At the same time,it was better than the 14 day group and the 29-42 day group,but it was not statistically significant.This study suggests that adjuvant chemotherapy on the 15-28 day may be the best time to increase DFS.3.The starting time of postoperative adjuvant chemotherapy was 14 days,15-28 days,29-42 days and 42 days,and their OS difference was statistically significant.In this study,the survival rate and median survival time of the 15-28 day group were the highest.4.From the results of multiple comparisons,OS in 15-28 days is better than that in42 days.At the same time,it was better than the 14 day group and the 29-42 day group,but it was not statistically significant.This study suggests that adjuvant chemotherapy on the 15-28 day may be the best time to increase OS.5.Combined with the above results,the 5 year disease-free survival rate and overall survival rate of the 15-28 day group were the highest.This study suggests that the first15-28 days after chemotherapy may be the best time to start chemotherapy for three negative breast cancer patients.6.The results of this study need to be further confirmed by large sample and multicenter studies. |
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