The Survival Outcomes of T1aN0M0 Triple-Negative Breast Cancer With Adjuvant Chemotherapy
Purpose: Triple-negative breast cancer (TNBC) is a subtype with distinct heterogeneity, high invasiveness, and poorer prognosis. There is a controversy about adjuvant chemotherapy (ACT) at the T1aN0M0 stage. This study was carried out to assess the survival benefit of ACT for these patients.Methods:...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.01753/full |
| _version_ | 1819206469308907520 |
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| author | Wen-Fen Fu Qing-Xia Chen Xiao-Xiao Wang Jie Zhang Chuan-Gui Song |
| author_facet | Wen-Fen Fu Qing-Xia Chen Xiao-Xiao Wang Jie Zhang Chuan-Gui Song |
| author_sort | Wen-Fen Fu |
| collection | DOAJ |
| description | Purpose: Triple-negative breast cancer (TNBC) is a subtype with distinct heterogeneity, high invasiveness, and poorer prognosis. There is a controversy about adjuvant chemotherapy (ACT) at the T1aN0M0 stage. This study was carried out to assess the survival benefit of ACT for these patients.Methods: We identified 1,099 patients with T1aN0M0 TNBC who were diagnosed between 2010 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariable analyses were conducted to determine factors related to survival. One-to-one (1:1) propensity score matching (PSM) was applied to construct a matched sample consisting of pairs of ACT and non-ACT subjects. Breast cancer–specific survival (BCSS) and overall survival (OS) of the two groups were evaluated by Kaplan–Meier plots and Cox proportional hazard regression models. Stratified analysis according to different variables was also performed.Results: No obvious differences in demographic or clinical characteristics were found between patients who had ACT and those without ACT therapy in terms of race, marital status, laterality, or radiation therapy. A higher proportion of patients who were older, had a higher histological grade tumor, and who received breast-conserving surgery had adjuvant chemotherapy. The ACT group did not exhibit better survival in BCSS or OS before PSM. After PSM, the ACT and non-ACT groups consisted of 255 patients, respectively, and Kaplan–Meier curves and multivariate analysis both indicate that adjuvant chemotherapy was not associated with better survival in terms of BCSS or OS. Furthermore, we did not observe any survival advantage in any subgroup irrespective of age, race, marital status, histological grade, surgery type, or radiotherapy status.Conclusions: The study results indicate that there is no strong association between ACT and better survival in T1aN0M0 TNBC. It implies that the chemotherapy decision should be made cautiously and further research into therapeutic strategies are needed in T1aN0M0 TNBC patients. |
| first_indexed | 2024-12-23T05:08:05Z |
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| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-23T05:08:05Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-ee8e7e4412eb42258b5ead800bd74e3b2022-12-21T17:59:01ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-09-011010.3389/fonc.2020.01753551615The Survival Outcomes of T1aN0M0 Triple-Negative Breast Cancer With Adjuvant ChemotherapyWen-Fen Fu0Qing-Xia Chen1Xiao-Xiao Wang2Jie Zhang3Chuan-Gui Song4Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Burn and Plastic Surgery, Affiliated Longyan First Hospital, Fujian Medical University, Longyan, ChinaDepartment of Gynecology and Obstetrics, Fujian Provincial Maternity and Children Health Hospital, Fuzhou, ChinaDepartment of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, ChinaPurpose: Triple-negative breast cancer (TNBC) is a subtype with distinct heterogeneity, high invasiveness, and poorer prognosis. There is a controversy about adjuvant chemotherapy (ACT) at the T1aN0M0 stage. This study was carried out to assess the survival benefit of ACT for these patients.Methods: We identified 1,099 patients with T1aN0M0 TNBC who were diagnosed between 2010 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariable analyses were conducted to determine factors related to survival. One-to-one (1:1) propensity score matching (PSM) was applied to construct a matched sample consisting of pairs of ACT and non-ACT subjects. Breast cancer–specific survival (BCSS) and overall survival (OS) of the two groups were evaluated by Kaplan–Meier plots and Cox proportional hazard regression models. Stratified analysis according to different variables was also performed.Results: No obvious differences in demographic or clinical characteristics were found between patients who had ACT and those without ACT therapy in terms of race, marital status, laterality, or radiation therapy. A higher proportion of patients who were older, had a higher histological grade tumor, and who received breast-conserving surgery had adjuvant chemotherapy. The ACT group did not exhibit better survival in BCSS or OS before PSM. After PSM, the ACT and non-ACT groups consisted of 255 patients, respectively, and Kaplan–Meier curves and multivariate analysis both indicate that adjuvant chemotherapy was not associated with better survival in terms of BCSS or OS. Furthermore, we did not observe any survival advantage in any subgroup irrespective of age, race, marital status, histological grade, surgery type, or radiotherapy status.Conclusions: The study results indicate that there is no strong association between ACT and better survival in T1aN0M0 TNBC. It implies that the chemotherapy decision should be made cautiously and further research into therapeutic strategies are needed in T1aN0M0 TNBC patients.https://www.frontiersin.org/article/10.3389/fonc.2020.01753/fulladjuvant chemotherapyT1aN0M0triple-negative breast cancerbreast cancer-specific survival (BCSS)overall survival (OS) |
| spellingShingle | Wen-Fen Fu Qing-Xia Chen Xiao-Xiao Wang Jie Zhang Chuan-Gui Song The Survival Outcomes of T1aN0M0 Triple-Negative Breast Cancer With Adjuvant Chemotherapy Frontiers in Oncology adjuvant chemotherapy T1aN0M0 triple-negative breast cancer breast cancer-specific survival (BCSS) overall survival (OS) |
| title | The Survival Outcomes of T1aN0M0 Triple-Negative Breast Cancer With Adjuvant Chemotherapy |
| title_full | The Survival Outcomes of T1aN0M0 Triple-Negative Breast Cancer With Adjuvant Chemotherapy |
| title_fullStr | The Survival Outcomes of T1aN0M0 Triple-Negative Breast Cancer With Adjuvant Chemotherapy |
| title_full_unstemmed | The Survival Outcomes of T1aN0M0 Triple-Negative Breast Cancer With Adjuvant Chemotherapy |
| title_short | The Survival Outcomes of T1aN0M0 Triple-Negative Breast Cancer With Adjuvant Chemotherapy |
| title_sort | survival outcomes of t1an0m0 triple negative breast cancer with adjuvant chemotherapy |
| topic | adjuvant chemotherapy T1aN0M0 triple-negative breast cancer breast cancer-specific survival (BCSS) overall survival (OS) |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.01753/full |
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