A Retrospective Study Of Surgical Treatment Of Primary Breast Cancer First Diagnosed From 2005 To 2017

Objective:The purpose of the present study was to study the distribution and trends over time of age of onset,clinical stages,pathological types,molecular types and surgical methods of breast cancer patients in the department of breast surgery,the first hospital of jilin university from 2005 to early 2017.Methods:Primary breast cancer admitted to the department of breast surgery of the first hospital of jilin university from January 1,2005 to December 31,2017 was collected and calculated using EXCEL.The 2005-2017 period is divided into four periods(2005-2008,2009-2011,2012-2014,and 2015-2017)that was respectively expressed by Q1,Q2,Q3 and Q4.Then the distribution and trend of the description clinical pathological features and surgical treatment of breast cancer were analysed with the application of SPSS software 26.Quantitative data used median,interquartile spacing,and Kruskal-wallis rank sum test was used for the analysis of single variables at different time periods.The chi-square test was used to compare the qualitative data,and P<0.05 was considered statistically significant.Results:The number of breast cancer patients increased year by year and the number of patients in different time periods increased in the 12 years.The median age of onset was 50(44-58)years old and the incidence peak age was 41-60 years old.The median ages of the four different time periods were 49,50,50 and 51 years old,respectively,with statistically significant differences(P=0.027).The distribution of different age groups(30,31-40,41-50,51-60,61-70-71-80,80-90)at different time periods had statistical significance(x~2=52.1,P<0.001).The group of<40 years old gradually decreased(Q1-Q4:16.8%-12.2%),and the group of 61-70 years old increased significantly(q1-q4:11.6%-17.1%).The distribution of clinical stages at different time periods was statistically significant(x~2=156.06,P=0.026).Stage 0 increased in Q1-Q2(2.9%4.4%)and declined in Q2-Q4(4.4%-1.1%).Stage I increased significantly(Q1-Q4:26.2%-42.6%).Stage II showed a downward trend(Q1-Q4:62.5-45.9%);Stage III increased significantly in Q3-Q4(7.1%-10.4%).There were statistically significant differences in the distribution of histological types at four different time periods(x~2=76.834,P=0.012).There was no significant change in the invasive lobular carcinoma and mucinous carcinoma and other carcinomas,with significant increase in the non-invasive and micro-invasive carcinomas in Q1-Q4(3.3%-5.2%0.1-3.9%,respectively).The distribution of molecular typing was different at different time periods(x~2=375.721,P<0.001).Luminal type increased significantly(Q1-Q4:30%-77.9%),while HER2overexpressed and triple negative breast cancer showed a decreasing trend in Q1-Q4(26.5%-10.5%,43.5%-11.5%,respectively)).The distribution of neoadjuvant therapy at four different time periods was statistically significant(likelihood ratio,x2=124.881,P<0.001).New adjuvant chemotherapy was significantly increased in Q1-Q3(5.0%-21.9%)and in Q3-Q4(21.9%-16.9%).Neoadjuvant endocrine therapy increased in Q1-Q4(0.0%-0.5%).There was a statistical significance in the distribution of surgical methods in different time periods(x ~2=1166.920,P<0.001).Modified radical declined in Q1-Q4(84.8%-33.8%),breast conservation surgery increased in Q1-Q2 14.1%-18.7%)and decreased in Q3-Q4 16.2%-7.6%).Total mastectomy showed a trend of increase in Q1-Q4(0.6%-47.9%).Breast reconstruction increased in Q1-Q4(0.5%-0.8%).The distribution of axillary lymph node treatment was statistically significant at different time periods(x~2=2165.814,P<0.001).SLNB significantly increased in Q1-Q4(0.6%-73.8%)and ALND declined in Q1-Q4(99.1%-25.1%).Conclusion:This study showed that the number of primary breast cancer admitted in the 12years was increasing year by year,The median age was 50(44-58)years old.The peak age being 41-60 years old.The<40 years old shows a decreasing trend,and the 61-70 years old shows an increasing trend.The proportion of early breast cancer was increasing.The most common pathological types were invasive non-specific carcinomas.Non-invasive and micro-invasive carcinomas increased,and the Luminal type increased significantly,while the HER2 overexpression type and triple negative type was decreasing.Neoadjuvant chemotherapy and neoadjuvant endocrine therapy are on the rise.The proportion of breast conserving surgery and mastectomy had been increasing,which has become the main surgical treatment at present,and the breast reconstruction was on the increase.Sentinel lymph node biopsy was the main treatment of axillary lymph nodes with an increasing trend.Through a retrospective analysis of the clinicopathological and surgical treatment of primary breast cancer patients admitted to a single center in the past 12 years,the results basically reflect the epidemiological characteristics of breast cancer and the changes and trends of surgical treatment in northeast China.The proportion of breast conserving surgery and breast reconstruction is lower,and further improvements is needed.