Series Analysis Of Breast Cancer Cases From 2012 To 2018

Objective:By analyzing the data of primary breast cancer patients registered with breast cancer disease management software in breast surgery department of SiChuan Provincial People's Hospital in the past 7 years,we can understand the distribution of clinical data of breast cancer patients in single center and their changes over time,and identify the survival influencing factors.Provide data for breast cancer prevention,screening and prognosis assessment.Methods:There are 2641 primary breast cancer patients registered in our sofeware during January 1,2012 to December 31,2018.Describe their distribution of general information?age of diagnosis,menstrual and reproductive status,BMI,residence,nationality,gender?,clinicopathological data?pathological typing,molecular typing,pathological staging,TNM staging,tumor location?and intervention methods?breast surgery,lymph node surgery,chemotherapy?and divide the total time interval into two approximately equal periods?January 1,2012 to December 31,2015 and January 1,2016,solstice,December31,2018?.The Chi-square test,the t-test and the rank sum test of two independent samples were used to compare and analyze the change of the research object in two time periods.The deadline for follow-up was June 1,2019,and COX regression model was used to analyze the influencing factors of survival status?time of death and survival?of breast cancer patients.Results:1.Distribution:In this study,the majority of breast cancer patients were female?99.2%?,mostly living in cities?66.2%?and mainly han nationality?95.9%?.The total age of diagnosis was 51.1±10.9 years,and the median age of diagnosis was 50 years.Among them,the middle-aged group?35-55 years old?had the highest incidence?61.9%?,and the age group with the highest incidence was 40-49 years old?37.6%?.In the situation of menstruation and fertility,the age of menarche?14 years old accounted for the majority?62.8%?.Breast cancer patients before menopause slightly more?51.5%?.in the menopausal population,more concentrated in the menopause age?50 years old population?69.8%?.BMI was in the normal range,followed by overweight and obese people?56.9%,32.1%and7.7%?.In the clinicopathologic data,The main pathological classification of breast cancer patients was invasive non-specific carcinoma?85.0%?,and the most common molecular classification was Luminal B type?48.8%?.The pathological staging is given priority to with the earlier stage??-???66.8%?.In TNM stage,the primary tumor diameter?5cm?T₁:46.7%;T₂:43.5%?,no lymph node metastasis or lymph node metastasis<1-3?N₀:56.1%;N₁:23.1%?,and no distant metastasis?M₀:91.3%?were more.2.Change in two time periods:The age of first diagnosis of breast cancer tends to be older?50.8±10.9 vs 51.7±10.9;t=2.210,P=0.027?.Breast cancer patients were diagnosed with more non-invasive cancers?0.6%vs 7.9%;c²=9.766,P=0.021?.There was a slight decrease in Luminal type of breast cancer and a slight increase in her-2 type?c²=8.251,P=0.041?.There was a tendency for larger primary tumors?Z=10.418,P=0.034?,fewer lymph node metastases?Z=22.612,P<0.001?,and more distant metastas-es?c²=61.185,P<0.001?in TNM staging.In terms of surgical procedures,the number of patients choosing prosthesis for breast surgery increased?2.2%vs 0.5%;c²=14.154,P=0.001?,while the number of patients choosing axillary lymph node surgery decreased and the number of patients choosing sentinel lymph node biopsy increased?c²=149.198,P<0.001?.3.Impact on prognosis:Univariate survival analysis showed that age of diagnosis,age of menarche,age of menopause,BMI value,place of residence,pathological classif-ication,pathological stage,N stage and M may be the risk factors affecting survival?P<0.05?.Multivaridta survival analysis confirmed that molecular typing,pathological staging,N staging and M staging were statistically significant for the prognosis of breas-t cancer patients?P<0.05?.Specifically,compared with LuminalA type,the molecular classification of triple-negative type and Her-2 type significantly increased the risk of death of patients?triple-negative type:HR=3.909,95%CI:1.562⁹.785;Her-2 type:HR=2.977,95%CI:1.165⁷.607?.For pathological staging,the risk of death significantly increased with staging compared to stage 0?stage?:HR=8.536,95%CI:1.156⁶3.060;stage?:HR=9.269,95%CI:1.243⁶9.134;stage?:HR=11.076,95%CI:1.287⁹5.310?.In addition,compared with N₀,the risk of death increased signifycan-tly with the increase in the number of lymph node metastases?N₁:HR=7.904,95%CI:3.782¹6.517;N₂:HR=10.166,95%CI:4.737²1.819;N₃:HR=17.887,95%CI:8.560³7.377?;Compare-d with M0,M1 also increased the risk of death?HR=2.318,95%CI:1.087⁴.946?.Conclusion:1.The majority of breast cancer patients are middle-aged and elderly women,and the diagnosis rate of young breast cancer is significantly lower,and the age of diagnosis has an increasing trend;In the menstrual condition,breast cancer patients are more concentrated in the late menarche age and early menopause age,which is inconsistent with the conventional thought of the risk of disease.And there are obvious differences in population distribution between urban and rural areas.2.The main types of breast cancer were invasive non-specific carcinoma and Luminal type,and the non-invasive carcinoma and her-2 type breast cancer had a slightly increased trend.In addition,the patients in this study were mostly early breast cancer with small primary tumor diameter,no or less lymph node metastasis and no distant lymph node metastasis.Although there were larger primary tumors and more distant metastasis changes,there were fewer lymph node metastasis.3.Total mastectomy and axillary lymph node dissection?Sentinel lymph node biopsy?are the most important surgical methods for breast cancer patients.Although there are few other surgical methods,in recent years,more patients are willing to choose the more beautiful?breast reconstruction surgery?and the smaller resection range?sentinel lymph node biopsy?.Anthracyclines combined with taxanes were the most common chemotherapy regimens for breast cancer,and no significant changes were observed.4.The prognosis of breast cancer patients is related to molecular typing,pathological stage,N and M status.Both triple-negative type and her-2 type can significantly affect the mortality risk of breast cancer patients,among which,tri-negative type breast cancer has a more significant impact on mortality than her-2 type breast cancer.The later the pathological stage,the higher the risk of death,and the manifestations are in N and M states.The risk of death increased significantly as the number of lymph node metastases and distant metastases increased.