超声体检出的乳腺癌生存率和复发相关病理及超声影像因素分析

Factors of survival rate, relapse-related pathology and ultrasound imaging of patients with breast cancer confirmed by ultrasound screen

目的分析超声体检出的乳腺癌患者的生存率和复发相关的病理及超声影像因素。方法我院2006年1月~2013年3月经超声体检出的501例乳腺癌女性患者,对其临床数据进行了回顾性分析。评价指标为5年总生存率(Overall survival,OS)和无复发(Relapse-free survival,RFS)生存率,同时收集患者的病理和超声影像数据。应用Cox比例风险回归进行多因素分析确定复发相关因素。结果在中位7年(5~12年)的随访期,有13例复发(2.6%,5例在同侧,8例在对侧),均为浸润性乳腺癌,原位癌未见复发。5年OS和RFS分别为100%和97%(95%CI:96.8%~99.2%)。在浸润性乳腺癌患者中,年龄<40岁[HR:3.648(95%CI:1.093~11.899),P=0.036],病理分子分型为三阴性亚型[HR:7.371(95%CI:2.266~24.812),P=0.002]和超声影像判定BI-RADS 4A类[HR:5.112(95%CI:1.536~17.186),P=0.010]与复发相关。结论超声体检筛查出的乳腺癌预后良好,年龄<40岁、三阴性亚型和BI-RADS 4A类是超声体检出的浸润性乳腺癌患者复发的独立危险因素。

Objective To analyze the factors of survival rate, relapse-related pathology and ultrasound(US) imaging of patients with breast cancer confirmed by US. Methods The study was a single-center retrospective analysis. The clinical data of 501 women with breast cancer confirmed by US between Jan 2006 and Mar 2013 were analyzed retrospectively. The evaluation index were 5-year overall survival (OS) and relapse-free survival rate (RFS). The data of pathology and ultrasound imaging were also collected. Cox proportional hazards regression model was used to determine the relapse factors by multivariate analysis. Results A total of 13 (2.6%) relapsed during the median follow-up of 7 years (5~12 years), 5 cases on the ipsilateral side and 8 cases on the contralateral side. All of them were invasive breast cancer, and no breast cancer in situ was found. The 5-year OS and RFS were 100% and 97%, respectively. In patients with invasive breast cancer, hazard ratio (HR) of age <40 years was 3.632 (95%CI :1.093~11.899, P=0.036), pathologic molecular typing as triple negative was 7.371 (95%CI :2.266~24.812, P=0.002), and ultrasound imaging graded as BI-RADS 4 A was 5.112 (95%CI :1.536~17.186, P=0.010), which were all associated with relapse. Conclusion Breast cancer confirmed by US screen showes good prognosis. Age <40 years, triple negative subtype and BI-RADS 4 A are independent risk factors for invasive breast cancer.