Abstract
BackgroundAccurate survival prediction of triple-negative breast cancer (TNBC) is essential in the decision-making of adjuvant treatment. The aim of this prospective study was to develop a nomogram that predicts overall survival and assists adjuvant treatment formulation.MethodsA total of 16,977 patients with pT1-2N0M0 TNBC between 2010 and 2015 from the SEER database were enrolled. Independent prognostic factors associated with overall survival (OS) were identified using univariate and multivariate Cox regression hazards method and utilized to compose the nomogram. The survival benefit of adjuvant treatment on OS were analyzed after stratification by nomogram sum-score.ResultsPatients were randomized 7:3 into the training and validation cohorts. Multivariate analysis revealed that age at diagnosis, grade, tumor size, laterality, and mastectomy type were independent prognostic factors of OS and were integrated to develop a nomogram for predicting prognosis. Patients were stratified into 3 prognostic subgroups according to the sum-score of our nomogram. There were no significant differences found in OS between surgery alone and other adjuvant treatment strategies in low risk group. In moderate risk group, patients receiving chemotherapy or the combination of chemotherapy and radiotherapy showed better OS than those receiving surgery alone or radiotherapy alone. For patients in high risk group, the combination of chemotherapy and radiotherapy could maximally improve the overall survival rate of patients.ConclusionA novel nomogram for OS prediction and risk stratification in patients with pT1-2N0M0 TNBC was developed. This cohort study reveals the prognostic roles of different adjuvant treatment strategies in subgroups, which may provide a reference for the decision-making of postoperative treatment, eventually improving prognosis for individual patients.
Highlights
Breast cancer (BC) is the most commonly diagnosed malignant tumor in women, with an estimated incidence of 2,76,000 new cases and 42,000 deaths annually in the United States alone [1]
This study aimed to construct a nomogram for predicting the probability of overall survival (OS) of patients with pT1-2N0M0 triple-negative breast cancer to assist the decision-making of postoperative adjuvant treatments
A total of 16,977 patients diagnosed with pT1-2N0M0 triplenegative breast cancer from the SEER database met the inclusion and exclusion criteria
Summary
Breast cancer (BC) is the most commonly diagnosed malignant tumor in women, with an estimated incidence of 2,76,000 new cases and 42,000 deaths annually in the United States alone [1]. Triple-negative breast cancer (TNBC), accounting for approximately 15% of all breast cancers cases, shows high malignancy, strong invasiveness, early metastasis, and poorer prognosis, reflecting the vital role of accurate survival prediction and individualized management after surgery for these patients [6, 7]. Previous studies have demonstrated that for T1-2N0M0 TNBC patients, receipt of adjuvant therapy was significantly associated with better overall survival, and delayed initiation of chemotherapy might induce worse outcomes [8, 9]. Accurate survival prediction of triple-negative breast cancer (TNBC) is essential in the decision-making of adjuvant treatment. The aim of this prospective study was to develop a nomogram that predicts overall survival and assists adjuvant treatment formulation
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