Analysis Of Clinical Efficacy And Prognostic Factors Of Neoadjuvant Chemotherapy Combined With Surgery In The Treatment Of Locally Advanced Breast Cancer

Objective: to explore the clinical efficacy of neoadjuvant chemotherapy in the treatment of locally advanced breast cancer and the related factors affecting the prognosis of locally advanced breast cancer.Methods: 77 cases of locally advanced breast cancer patients treated in the first affiliated hospital of Nanchang university from November 2011 to November 2013 were retrospectively collected,among which 26 cases were treated with neoadjuvant chemotherapy(observation group)and 51 cases were treated without neoadjuvant chemotherapy(control group).The operative conditions,postoperative complications,postoperative recurrence and metastasis rates,and survival rates of the two groups were compared,and the related factors affecting the prognosis of patients with locally advanced breast cancer were statistically analyzed.Results: 1.There was no significant difference in age,menstrual status,tumor site,tumor size,axillary lymph node status,clinical TNM stage,pathological type,histological grade,molecular typing,chemotherapy regimen and follow-uptime between the two groups(P > 0.05).2.Incision infection,subcutaneous effusion and upper limb edema were not statistically significant in the two groups(P > 0.05).3.The difference of operative time and intraoperative blood loss between the two groups was statistically significant.The operative time was(148.77�67.44min)vs(184.00� 48.31min),P=0.010.Intraoperative blood loss was(113.46�68.00ml)vs(156.86� 92.38ml),P=0.037.There was no significant difference in lymph node metastasis(P > 0.05).4.There were no significant differences in local recurrence,distant metastasis,disease-free survival rate and overall survival rate between the two groups at 1,3 and 5 years(P > 0.05).5.Coxregression model showed that clinical TNM staging and molecular typing were independent risk factors affecting the overall survival rate of patients with locally advanced breast cancer.Patients with high clinical TNM staging had a higher risk of death than those with low clinical TNM staging,HR=1.764(95%CI: 1.259-2.470).Patients with tri-negative molecular typing had a higher risk of death than patients with lumina,HR=1.775(95%CI: 1.210-2.603).Conclusion: 1.Neoadjuvant chemotherapy is safe and effective in the treatment of locally advanced breast cancer,which reduces the operation time and intraoperative blood loss,and does not increase the incidence of postoperative complications,as well as the risk of recurrence,metastasis and death.2.Univariate analysis found that tumor size,clinical stage and molecular typing were closely related to the survival and prognosis of locally advanced breast cancer patients.3.Clinical TNM stage and molecular typing are independent risk factors affecting the overall survival rate of patients with locally advanced breast cancer,so early diagnosis is the key factor to improve the treatment effect of locally advanced breast cancer.