Analysis Of Clinical Features And Prognostic Factors Of Triple Positive Breast Cancer Based On Databases

Background&objective:Triple-positive breast cancer is one of the special molecular subtype of breast cancer.characterized by the expression of ER?PR?HER-2.sensitive to chemotherapy?targeted therapy.endocrine therapy.Theoretically.combination therapy for its effect would be more effective.however.the treatment of TPBC did not achieve the desired prognosis.The future research should focus on the exploration of characteristics and related prognostic factors,it can provide more scientific and rational personalized treatment for this type of patients.Methods:The Surveillance.Epidemiology,and End Results Program(SEER)and Subei hospital's data were used to analyze clinical data and compared each other.Followed by using the Kaplan-Meier method Survival curves were plotted and Cox proportional hazards regression model,the univariate analysis and multivariate analysis were performed to investigate survival factors associated with overall survival(OS)and breast cancer-specific survival BCSS)of tri-positive breast cancer.Results:A total of 130.666 female patients with SEER data were included in the study.including 9.900(7.6%)of the Tri-positive breast cancer.and 99 of the TPBC patients rom Subei hospital's data.The majority of patients were white,7.591(76.7%).mostly married women,the age of onset was 46-60 years old.were 5.686(42.0%).and the proportion of patients under 45 years old was 22.5%higher than other subtypes.There were 54 patients(54.4%)with 46-60 years old in our hospital.and the proportion of patients aged 31-45 years was higher than SEER data.30(30.3%)VS 2043(20.6%).Tumor grade was relatively low.The ? and ? grades were 732(7.4%)and 4025(40.7%)respectively.The proportion of grade I in this hospital was slightly lower than that of SEER,but the ratio of grade ? and grade ? was relatively high.were 41(41.4%)and 54 cases(54.5%).Compared with the HoR+/HER2-,patients with T1 tumor proportion was slightly lower.4.402(44.5%).but tumor size was T2 and T3 were high,4.080(41.2%)and 1103(10.1%).C:ompared with our data.there were 72 cases(72.7%)with T2 tumor in this study.There were 5.366 cases(54.2%)with NO stage.but 2.3 1 8 cases(23.4%)had the highest proportion in the N1 stage worthy of attention,followed by the N2 and N3 stages in the second place.The incidence rate of N2 and N3 in this hospital was significantly higher than that of SEER.which was 18 cases(18.2%)VS 729(7.4%)and 10 cases(1 0.1%)VS 326 cases(3.3%).Most patients underwent surgery,with the highest proportion of breast-conserving surgery.4.498(45.4%).And 7.015 patients(70,9%)received chemotherapy.4.598(76.5%)cases in the HoR-/HER2+group and 11.422(73.4%)patients in the TNBC group.Patients in this hospital have basically undergone radical mastectomy and chemotherapy.As of the follow-up date,1151(11.6%)of the TPBC patients died,of which 701(60.9%)died of breast cancer,with a median survival of 49 months.The OS and BCSS of this type of patients were in second place,slighty worse than HoR+/HER2-group,and better than HR-/HER2+type patients(.P<0.001)Univariate and multivariate analysis showed that race.age.marital status.histoloaical grade.tumor size.lymph node staging.surgery and chemotherapy were all prognostic factors affecting different molecular breast cancer patients(P<0.05).COX risk analysis found that TPBC chemotherapy benefited a wider population.In the subgroup analysis.tumors were less than 0.5 cm in diameter,and only TPBC benefited from chemotherapy(P=0.041).Patients who underwent surgery significantly prolonged survival compared with non-surgical patients.with the highest benefit rate being breast-conserving patients,followed by total resection(P<0.001).Whether patients received targeted therapy had no significant effect on patient outcomes only in the local data(P=0.76)Conclusion:(1)Tri-positive breast cancer accounted for 7.6%of the total breast cancer cases,the age lower than other subtypes.and the grade and stage were earlier,but the proportion of lymph nodes or distant metastases was higher than other types.(2)The age.race,marital status,histological grade,tumor size.lymph node staging,surgery and chemoradiotherapy were significantly associated with OS.(3)Through the analysis of the SEER data.the prognosis of patients with tripie-positive breast cancer experienced chemotherapy was significantly better than that of non-chemotherapy group,with a w.ide range of benefit groups.(4)Patients in our hospital have lower age than onset.poor pathological features of tumors.low proportion of breast-conserving,and high proportion of chemotherapy.The benefits of targeted therapy are different from previous studies and need further study and discussion.On the whole,there are still differences in the treatment decisions of Chinese patients and abroad,which needs attention.