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Abstract：
UNASSIGNED: Few studies have focused specifically on prognostic factors and optimal surgical intervention for early-onset triple-negative breast cancer (eTNBC), which is characterized by high malignancy and poor prognosis.
UNASSIGNED: We performed a cohort study with a median follow-up of 31 months using Surveillance, Epidemiology, and End Results (SEER) data of patients diagnosed with stages I-III eTNBC between 2010 and 2016. In addition, we collected cases between 2006 and 2016 from our center as an external validation set. Clinical features, pathologic characteristics and oncologic outcomes were analyzed. Prognostic factors for overall survival (OS) and breast cancer-specific survival (BCSS) were determined by Cox proportional hazards analyses and were incorporated into the prognostic nomogram. Subgroup analysis based on propensity score matching method was conducted to explore the subset of patients that would benefit from breast-conserving therapy (BCT).
UNASSIGNED: Based on SEER dataset, patients with eTNBC were more likely to undergo mastectomy than BCT. On multivariable analysis, patients with better survival outcomes were those not married, uninsured, had higher T and N stage, and had histological type of mixed invasive ductal and lobular carcinoma. The prognostic nomogram based on these variables successfully predicted the 3- and 5-year BCSS (C-index in training cohort, 0.774; in validation cohort from SEER, 0.768; in validation cohort from our center, 0.723). Subgroup analysis illustrated that patients with T1N0M0 or T2-4N+M0 tumors who underwent BCT achieved longer overall survival than those who underwent mastectomy (for T1N0M0, P = 0.022; for T2-4N+M0, P = 0.003); however, the type of surgery did not influence OS among patients with T1N+M0 or T2-4N0M0 tumors (for T1N+M0, P = 0.305; for T2-4N0M0, P = 0.317).
UNASSIGNED: The prognosis of patients with eTNBC is mainly affected by marital status, insurance status, T stage, N stage and histological type. The prognostic nomogram based on these factors is quite reliable. Subgroup analysis suggested that BCT may be a superior option for patients with eTNBC, especially those with T1N0M0 and T2-4N+M0 tumors.
UNASSIGNED: We performed a cohort study with a median follow-up of 31 months using Surveillance, Epidemiology, and End Results (SEER) data of patients diagnosed with stages I-III eTNBC between 2010 and 2016. In addition, we collected cases between 2006 and 2016 from our center as an external validation set. Clinical features, pathologic characteristics and oncologic outcomes were analyzed. Prognostic factors for overall survival (OS) and breast cancer-specific survival (BCSS) were determined by Cox proportional hazards analyses and were incorporated into the prognostic nomogram. Subgroup analysis based on propensity score matching method was conducted to explore the subset of patients that would benefit from breast-conserving therapy (BCT).
UNASSIGNED: Based on SEER dataset, patients with eTNBC were more likely to undergo mastectomy than BCT. On multivariable analysis, patients with better survival outcomes were those not married, uninsured, had higher T and N stage, and had histological type of mixed invasive ductal and lobular carcinoma. The prognostic nomogram based on these variables successfully predicted the 3- and 5-year BCSS (C-index in training cohort, 0.774; in validation cohort from SEER, 0.768; in validation cohort from our center, 0.723). Subgroup analysis illustrated that patients with T1N0M0 or T2-4N+M0 tumors who underwent BCT achieved longer overall survival than those who underwent mastectomy (for T1N0M0, P = 0.022; for T2-4N+M0, P = 0.003); however, the type of surgery did not influence OS among patients with T1N+M0 or T2-4N0M0 tumors (for T1N+M0, P = 0.305; for T2-4N0M0, P = 0.317).
UNASSIGNED: The prognosis of patients with eTNBC is mainly affected by marital status, insurance status, T stage, N stage and histological type. The prognostic nomogram based on these factors is quite reliable. Subgroup analysis suggested that BCT may be a superior option for patients with eTNBC, especially those with T1N0M0 and T2-4N+M0 tumors.
摘要：
未经证实：很少有研究专门针对早发性三阴性乳腺癌（eTNBC）的预后因素和最佳手术干预。恶性程度高，预后差。
UNASSIGNED：我们进行了一项队列研究，中位随访时间为31个月，流行病学,2010年至2016年诊断为I-III期eTNBC的患者的最终结果（SEER）数据。此外,我们从我们中心收集了2006年至2016年间的病例作为外部验证集.临床特征,分析了病理特征和肿瘤学结果.通过Cox比例风险分析确定总体生存率（OS）和乳腺癌特异性生存率（BCSS）的预后因素，并将其纳入预后列线图。基于倾向评分匹配方法进行亚组分析，以探索将从保乳治疗（BCT）中受益的患者亚组。
未经评估：基于SEER数据集，eTNBC患者比BCT更有可能接受乳房切除术.在多变量分析中，生存结果较好的患者是那些未婚的患者，没有保险,有较高的T和N阶段，组织学类型为浸润性导管和小叶混合癌。基于这些变量的预后列线图成功预测了3年和5年的BCSS(训练队列中的C指数，0.774；在SEER的验证队列中，0.768；在我们中心的验证队列中，0.723).亚组分析表明，接受BCT的T1N0M0或T2-4NM0肿瘤患者的总生存期比接受乳房切除术的患者长（对于T1N0M0，P=0.022；对于T2-4NM0，P=0.003）；但是，手术类型不影响T1N+M0或T2-4N0M0肿瘤患者的OS(对于T1N+M0,P=0.305;对于T2-4N0M0,P=0.317).
UNASSIGNED：eTNBC患者的预后主要受婚姻状况的影响，保险状况,T级,N分期和组织学类型。基于这些因素的预后列线图是相当可靠的。亚组分析表明，BCT可能是eTNBC患者的首选选择，尤其是T1N0M0和T2-4N+M0肿瘤。
UNASSIGNED：我们进行了一项队列研究，中位随访时间为31个月，流行病学,2010年至2016年诊断为I-III期eTNBC的患者的最终结果（SEER）数据。此外,我们从我们中心收集了2006年至2016年间的病例作为外部验证集.临床特征,分析了病理特征和肿瘤学结果.通过Cox比例风险分析确定总体生存率（OS）和乳腺癌特异性生存率（BCSS）的预后因素，并将其纳入预后列线图。基于倾向评分匹配方法进行亚组分析，以探索将从保乳治疗（BCT）中受益的患者亚组。
未经评估：基于SEER数据集，eTNBC患者比BCT更有可能接受乳房切除术.在多变量分析中，生存结果较好的患者是那些未婚的患者，没有保险,有较高的T和N阶段，组织学类型为浸润性导管和小叶混合癌。基于这些变量的预后列线图成功预测了3年和5年的BCSS(训练队列中的C指数，0.774；在SEER的验证队列中，0.768；在我们中心的验证队列中，0.723).亚组分析表明，接受BCT的T1N0M0或T2-4NM0肿瘤患者的总生存期比接受乳房切除术的患者长（对于T1N0M0，P=0.022；对于T2-4NM0，P=0.003）；但是，手术类型不影响T1N+M0或T2-4N0M0肿瘤患者的OS(对于T1N+M0,P=0.305;对于T2-4N0M0,P=0.317).
UNASSIGNED：eTNBC患者的预后主要受婚姻状况的影响，保险状况,T级,N分期和组织学类型。基于这些因素的预后列线图是相当可靠的。亚组分析表明，BCT可能是eTNBC患者的首选选择，尤其是T1N0M0和T2-4N+M0肿瘤。
