ObjectiveTo compare the clinicopathological features of Luminal A breast cancer patients in early and middle stage, and locally advanced Luminal A breast cancer, then the influencing factors of disease-free survival (DFS) in locally advanced Luminal A breast cancer patients were further discussed.MethodsFrom January 2010 to December 2012, 295 Luminal A breast cancer patients who completed diagnosis, treatment, and follow-up in our hospital were retrospectively collected. According to TNM stage, 227 cases of early and middle breast cancer and 68 cases of locally advanced breast cancer were divided into two groups. Chi-square test or rank sum test was used to compare the clinicopathological characteristics of patients between the two groups, and log-rank test and Cox proportional risk regression model were used to explore the influencing factors of 5-year DFS situation in patients with locally advanced Luminal A breast cancer.ResultsT stage and N stage were later in locally advanced Luminal A breast cancer patients than that of the early and middle breast cancer patients (P<0.05), and the tumor grade was higher in locally advanced Luminal A breast cancer patients (P<0.05). The 5-year DFS rate was 87.8% (259/295). In this study, there were5 comprehensive treatment schemes as follows: neoadjuvant chemotherapy + surgery + radiotherapy + endocrine therapy, neoadjuvant chemotherapy + surgery + endocrine therapy, surgery + chemotherapy + radiotherapy + endocrine therapy, surgery + chemotherapy + endocrine therapy, and surgery + radiotherapy + endocrine therapy. The 5-year DFS rate of locally advanced Luminal A breast cancer patients was lower than that of the early and middle Luminal A breast cancer patients (76.5% vs. 91.2%, P=0.001). Univariate analysis showed that T stage (χ2=8.248, P=0.040), N stage (χ2=9.470, P=0.024), vascular invasion (χ2=4.211, P=0.031), and tumor grade (χ2=6.985, P=0.030) were the factors influencing the5-year DFS situation of locally advanced Luminal A breast cancer patients. Multivariate analysis showed that T staging (HR=5.062, P<0.001) and N staging (HR=7.075, P<0.001) were the influencing factors for 5-year DFS situation in locally advanced Luminal A breast cancer patients. The later the T stage and N stage, the worse the 5-year DFS situation.ConclusionsT stage and N stage are independent risk factors for prognosis of patients with locally advanced Luminal A breast cancer. Individualized comprehensive treatment program is an important guarantee for improving the 5-year DFS rate of this kind of patients.
ObjectiveTo investigate the effect and predictive value of systemic inflammatory markers on pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) for locally advanced breast cancer (LABC). MethodsThe clinicopathologic data of female patients with LABC who received NACT and radical surgical resection in the Department of Breast Surgery, Affiliated Hospital of Southwest Medical University from February 2019 to February 2022 were retrospectively analyzed. The factors affecting pCR after NACT were analyzed by the multivariate logistic regression and the prediction model was established. The efficiency of the prediction model was evaluated by receiver operating characteristic (ROC) curve and area under the ROC curve (AUC). ResultsA total of 98 patients were gathered, of which 29 obtained pCR, with a pCR rate of 29.6%. The multivariate analysis of binary logistic regression showed that the patients with non-menopausal status, negative estrogen receptor (ER), chemotherapy+targeted therapy, and systemic immune-inflammation index (SII) <532.70 (optimal critical value) were more likely to obtain pCR after NACT (P<0.05). The prediction model was established according to logistic regression analysis: Logit (P)=0.697–2.974×(menopausal status)–1.932×(ER status)+3.277×(chemotherapy regimen)–2.652×(SII). The AUC (95%CI) of the prediction model was 0.914 (0.840, 0.961), P<0.001. ConclusionsIt is not found that other inflammatory indicators such as neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio are associated with pCR after NACT. But SII is an important predictor of pCR after NACT for LABC and has a good predictive efficiency.