Factors and prediction schemes of recurrence of triple negative breast cancer after breast conserving surgery based on case-control trials
10.3969/j.issn.1009-9905.2025.09.004
- VernacularTitle:基于病例对照试验分析三阴性乳腺癌保乳术后复发的因素及预测方案
- Author:
Ning ZHANG
1
;
Liang-quan YANG
1
Author Information
1. 秦皇岛市妇幼保健院 乳腺科(河北 秦皇岛 066000)
- Publication Type:Journal Article
- Keywords:
Triple negative breast cancer;
Breast conserving surgery;
Case-control studies;
Recurrence;
Nomo-gram model
- From:
Chinese Journal of Current Advances in General Surgery
2025;28(9):692-696
- CountryChina
- Language:Chinese
-
Abstract:
Objective:The influence factors of recurrence of triple negative breast cancer(TNBC)after breast con-serving surgery were analyzed based on case-control trials,and the prediction scheme was constructed accordingly.Method:The clinical data of 186 TNBC patients treated with breast conserving surgery from January 2022 to August 2023 were retrospectively analyzed,and the postoperative recurrence of TNBC patients was counted.The recurrent pa-tients were selected as the case group,while age,parity,pregnancy,and family history were used as matching variables,and non-recurrent patients were matched in a 1∶1 ratio as the control group.The clinical data of the two groups was compared.The influence factors of recurrence of TNBC after breast conserving surgery was analyzed by Cox model,and the nomogram model of recurrence after TNBC breast conserving surgery was drawn.The nomogram was internally verified by Bootstrap method.The calibration curve and ROC curve were used to evaluate the calibration and predictive efficacy of the model.Results:All of the 186 TNBC patients,60 cases had recurrence after breast conserving surgery,with an incidence of 32.26%.The proportions of invasive ductal carcinoma,TNM stage III,tumor size>3cm,lymph node metastasis ratio,and the levels of neutrophil/lymphocyte ratio(NLR)and proliferating cell antigen(Ki-67)in the case group were higher than those in the control group(P<0.05).The results of Cox model analysis showed that invasive duc-tal carcinoma,TNM stage Ⅲ,tumor size>3 cm,lymph node metastasis,and increased levels of NLR and Ki-67 were all risk factors for recurrence of TNBC after breast conserving surgery(P<0.05).The consistency index of the nomogram model constructed according to the above influence factors verified by Bootstrap method was 0.886.The calibration curve fitted well with the ideal curve.The ROC curve showed that the area under the curve,sensitivity and specificity of the nomogram model for predicting the recurrence of TNBC after breast conserving surgery were 0.837,71.67%and 85.00%,respectively.Conclusion:Invasive ductal carcinoma,TNM stage Ⅲ,tumor size>3 cm,lymph node metasta-sis,and increased levels of NLR and Ki-67 are all risk factors for recurrence of TNBC after breast conserving surgery,and the nomogram model constructed based on this has good predictive efficacy.