Background
Methods
Study population and data sources
Survival analysis and propensity matching
Statistical analysis
Result
Patient characteristics
Characteristics | Before PSM (2267) | After PSM (1066) | ||||
---|---|---|---|---|---|---|
No RT | RT | P-value | No RT | RT | P-value | |
Age at diagnosis | < 0.05 | 0.057 | ||||
< 60 | 504 (42.7%) | 592 (54.5%) | 264 (49.5%) | 296 (55.5%) | ||
≥ 60 | 677 (57.3%) | 494 (45.5%) | 269 (50.5%) | 237 (44.5%) | ||
Ethnicity |
< 0.05
| 0.667 | ||||
White | 929 (78.7%) | 825 (76.0%) | 402 (75.4%) | 408 (76.5%) | ||
Black | 163 (13.8%) | 190 (17.5%) | 95 (17.8%) | 85 (15.9%) | ||
Others | 89 (7.5%) | 71 (6.5%) | 36 (6.8%) | 40 (7.5%) | ||
Marital status | 0.263 | 0.736 | ||||
Single | 185 (15.7%) | 151 (13.9%) | 86 (16.1%) | 81 (15.2%) | ||
Married | 996 (84.3%) | 935 (86.1%) | 447 (83.9%) | 452 (84.8%) | ||
Grade | 0.539 | 0.472 | ||||
G1 | 64 (5.4%) | 56 (5.2%) | 23 (4.3%) | 24 (4.5%) | ||
G2 | 173 (14.6%) | 137 (12.6%) | 66 (12.4%) | 69 (12.9%) | ||
G3 | 888 (75.2%) | 839 (77.3%) | 416 (78.0%) | 400 (75.0%) | ||
G4 | 56 (4.7%) | 54 (5.0%) | 28 (5.3%) | 40 (7.5%) | ||
ER status | 0.413 | 0.456 | ||||
Negative | 979 (82.9%) | 885 (81.5%) | 451 (84.6%) | 441 (82.7%) | ||
Positive | 202 (17.1%) | 201 (18.5%) | 82 (15.4%) | 92 (17.3%) | ||
PR status | 0.058 | 0.192 | ||||
Negative | 1044 (88.4%) | 930 (85.6%) | 475 (89.1%) | 460 (86.3%) | ||
Positive | 137 (11.6%) | 156 (14.4%) | 58 (10.9%) | 73 (13.7%) | ||
Stage T |
< 0.05
| 0.457 | ||||
≤ 5 cm | 937 (79.3%) | 814 (75.0%) | 373 (70.0%) | 385 (72.2%) | ||
> 5 cm | 244 (20.7%) | 272 (25.0%) | 160 (30.0%) | 148 (27.8%) | ||
Stage N | 0.090 | 0.202 | ||||
N0 | 929 (78.7%) | 811 (74.7%) | 381 (71.5%) | 382 (71.7%) | ||
N1 | 173 (14.6%) | 195 (18.0%) | 96 (18.0%) | 112 (21.0%) | ||
N2 | 51 (4.3%) | 45 (4.1%) | 35 (6.6%) | 22 (4.1%) | ||
N3 | 28 (2.4%) | 35 (3.2%) | 21 (3.9%) | 17 (3.2%) | ||
Stage TNM |
< 0.05
| 0.848 | ||||
I | 247 (20.9%) | 283 (26.1%) | 109 (20.5%) | 115 (21.6%) | ||
II | 779 (66.0%) | 605 (55.7%) | 314 (58.9%) | 314 (58.9%) | ||
III | 155 (13.1%) | 198 (18.2%) | 110 (20.6%) | 104 (19.5%) | ||
Breast operation |
< 0.05
| 0.667 | ||||
Lumpectomy | 254 (21.5%) | 692 (63.7%) | 248 (46.5%) | 240 (45.0%) | ||
Mastectomy | 927 (78.5%) | 394 (36.3%) | 285 (53.5%) | 293 (55.0%) | ||
Chemotherapy |
< 0.05
| 0.111 | ||||
Not done/unknown | 548 (46.4%) | 254 (23.4%) | 176 (33.0%) | 151 (28.3%) | ||
Done | 633 (53.6%) | 832 (76.6%) | 357 (67.0%) | 382 (71.7%) | ||
Axilla LN operation |
0.050
| 0.425 | ||||
SLNB | 581 (49.2%) | 580 (53.4%) | 261 (49.0%) | 247 (46.3%) | ||
ALND | 600 (50.8%) | 506 (46.6%) | 272 (51.0%) | 286 (53.7%) |
Survival analyses in the whole SEER cohort
Characteristics | Univariate | Multivariate | ||||||
---|---|---|---|---|---|---|---|---|
OS | BCSS | OS | BCSS | |||||
HR (95% CI) | P-value | HR (95% CI) | P-value | HR (95% CI) | P-value | HR (95% CI) | P-value | |
Age at diagnosis (< 60 as ref.) | ||||||||
≥ 60 | 1.92 (1.63–2.26) |
< 0.01
| 1.23 (1.02–1.48) | < 0.05 | 1.81 (1.51–2.16) |
< 0.01
| 1.36 (1.11–1.66) |
< 0.001
|
Race (white as ref.) | ||||||||
Black | 1.02 (0.82–1.27) | 0.843 | 1.12 (0.88–1.43) | 0.364 | 1.01 (0.81–1.26) | 0.958 | 0.97 (0.76–1.25) | 0.828 |
Others | 0.91 (0.65–1.26) | 0.583 | 0.98 (0.68–1.42) | 0.922 | 0.95 (0.69–1.32) | 0.763 | 0.97 (0.67–1.41) | 0.872 |
Marital status (single as ref.) | ||||||||
Married | 0.92 (0.74–1.14) | 0.449 | 0.78 (0.62–1.00) |
< 0.05
| 0.93 (0.74–1.17) | 0.54 | 0.92 (0.71–1.18) | 0.506 |
Grade (G1 as ref.) | ||||||||
G2 | 1.23 (0.79–1.93) | 0.36 | 1.08 (0.61–1.92) | 0.786 | 1.08 (0.69–1.69) | 0.747 | 0.93 (0.52–1.65) | 0.801 |
G3 | 1.5 (1.01–2.25) | < 0.05 | 1.77 (1.07–2.92) | < 0.05 | 1.18 (0.78–1.77) | 0.438 | 1.14 (0.69–1.9) | 0.605 |
G4 | 1.94 (1.20–3.15) | < 0.01 | 2.50 (1.40–4.49) | < 0.01 | 1.56 (0.96–2.54) | 0.076 | 1.65 (0.92–2.98) | 0.095 |
ER status (negative as ref.) | ||||||||
Positive | 0.9 (0.73–1.12) | 0.36 | 0.88 (0.68–1.13) | 0.318 | 0.88 (0.68–1.14) | 0.316 | 0.8 (0.59–1.08) | 0.146 |
PR status (negative as ref.) | ||||||||
Positive | 0.8 (0.62–1.03) | 0.077 | 0.87 (0.66–1.16) | 0.339 | 0.81 (0.60–1.09) | 0.162 | 0.95 (0.68–1.34) | 0.779 |
Stage T (≤ 5 cm as ref.) | ||||||||
> 5 cm | 3.65 (3.11–4.28) | < 0.01 | 4.55 (3.79–5.46) | < 0.001 | 2.92 (2.44–3.49) | < 0.01 | 3.44 (2.79–4.24) | < 0.001 |
Stage N (N0 as ref.) | ||||||||
N1 | 1.79 (1.48–2.17) | < 0.01 | 2.35 (1.89–2.91) | < 0.001 | 1.55 (1.26–1.91) | < 0.01 | 1.78 (1.41–2.25) | < 0.001 |
N2 | 3.45 (2.60–4.59) | < 0.01 | 4.01 (2.91–5.52) | < 0.001 | 2.55 (1.88–3.46) | < 0.01 | 2.49 (1.76–3.51) | < 0.001 |
N3 | 3.86 (2.78–5.36) | < 0.01 | 5.03 (3.54–7.17) | < 0.001 | 2.91 (2.06–4.11) | < 0.01 | 3.33 (2.29–4.84) | < 0.001 |
Breast operation (lumpectomy as ref.) | ||||||||
Mastectomy | 2.56 (2.14–3.06) | < 0.01 | 2.75 (2.22–3.41) | < 0.001 | 1.3 (1.05–1.61) | < 0.05 | 1.32 (1.02–1.70) | < 0.05 |
Chemotherapy (not done/unknown as ref.) | ||||||||
Done | 0.62 (0.53–0.72) | < 0.01 | 0.99 (0.82–1.2) |
0.934
| 0.71 (0.60–0.85) | < 0.001 | 1.02 (0.82–1.27) | 0.848 |
Radiotherapy (not done as ref.) | ||||||||
Done | 0.62 (0.53–0.73) | < 0.001 | 0.73 (0.61–0.88) | < 0.001 | 0.73 (0.61–0.88) |
0.001
| 0.71 (0.58–0.88) | < 0.01 |
Axilla LN operation (SLNB as ref.) | ||||||||
ALND | 1.91 (1.62–2.25) | < 0.001 | 2.18 (1.79–2.65) | < 0.001 | 1.17 (0.97–1.42) | 0.096 | 1.14 (0.91–1.43) | 0.254 |
Survival analysis in propensity score-matched cohort
Characteristics | Univariate | Multivariate | ||||||
---|---|---|---|---|---|---|---|---|
OS | BCSS | OS | BCSS | |||||
HR (95% CI) | P-value | HR (95% CI) | P-value | HR (95% CI) | P-value | HR (95% CI) | P-value | |
Age at diagnosis (< 60 as ref.) | ||||||||
≥ 60 | 1.49 (1.20–1.85) | < 0.001 | 1 (0.78–1.289) | 0.987 | 1.6 (1.26–2.05) | < 0.001 | 1.23 (0.94–1.62) | 0.138 |
Race (white as ref.) | ||||||||
Black | 1.18 (0.89–1.60) | 0.243 | 1.22 (0.89–1.68) | 0.22 | 1.03 (0.77–1.39) | 0.842 | 0.95 (0.68–1.32) | 0.755 |
Others | 0.96 (0.61–1.49) | 0.842 | 1.07 (0.66–1.73) | 0.798 | 1.09 (0.69–1.71) | 0.723 | 1.06 (0.65–1.74) | 0.813 |
Marital status (single as ref.) | ||||||||
Married | 0.7 (0.53–0.94) | < 0.05 | 0.62 (0.46–0.84) | < 0.01 | 0.68 (0.50–0.91) |
0.01
| 0.68 (0.49–0.95) | < 0.05 |
Grade (G1 as ref.) | ||||||||
G2 | 0.98 (0.48–2.01) | 0.958 | 0.8 (0.33–1.93) | 0.617 | 0.96 (0.47–1.98) | 0.918 | 0.8 (0.33–1.94) | 0.62 |
G3 | 1.58 (0.84–2.97) | 0.155 | 1.8 (0.85–3.82) | 0.127 | 1.23 (0.65–2.32) | 0.529 | 1.26 (0.59–2.68) | 0.557 |
G4 | 1.34 (0.64–2.80) | 0.439 | 1.58 (0.67–3.77) | 0.299 | 1.34 (0.64–2.81) | 0.443 | 1.44 (0.60–3.44) | 0.411 |
ER status (negative as ref.) | ||||||||
Positive | 0.82 (0.60–1.14) | 0.239 | 0.84 (0.59–1.21) | 0.353 | 0.83 (0.57–1.21) | 0.331 | 0.76 (0.50–1.15) | 0.19 |
PR status (negative as ref.) | ||||||||
Positive | 0.63 (0.43–0.93) | < 0.05 | 0.77 (0.51–1.15) | 0.204 | 0.67 (0.43–1.04) | 0.074 | 0.89 (0.56–1.42) | 0.627 |
Stage T (≤ 5 cm as ref.) | ||||||||
> 5 cm | 3.84 (3.08–4.78) | < 0.001 | 4.41 (3.44–5.66) | < 0.001 | 2.99 (2.31–3.86) | < 0.001 | 3.18 (2.39–4.24) | < 0.001 |
Stage N (N0 as ref.) | ||||||||
N1 | 1.56 (1.20–2.05) |
0.001
| 2.02 (1.51–2.71) | < 0.001 | 1.21 (0.91–1.61) | 0.191 | 1.43 (1.04–1.95) | < 0.05 |
N2 | 2.91 (2.02–4.20) | < 0.001 | 3.29 (2.19–4.95) | < 0.001 | 1.84 (1.24–2.72) | < 0.01 | 1.82 (1.17–2.82) | < 0.01 |
N3 | 3.27 (2.14–5.00) | < 0.001 | 4.04 (2.55–6.40) | < 0.001 | 2.2 (1.39–3.48) |
0.001
| 2.41 (1.46–3.98) |
0.001
|
Breast operation (lumpectomy as ref.) | ||||||||
Mastectomy | 2.6 (2.04–3.31) | < 0.001 | 3.18 (2.38–4.25) | < 0.001 | 1.46 (1.08–1.98) | < 0.05 | 1.52 (1.06–2.18) | < 0.05 |
Chemotherapy (not done/unknown as ref.) | ||||||||
Done | 0.84 (0.67–1.05) | 0.12 | 1.35 (1.02–1.80) | < 0.05 | 0.75 (0.58–1.00) | < 0.05 | 1.08 (0.79–1.48) | 0.617 |
Radiotherapy (not done as ref.) | ||||||||
Done | 0.62 (0.50–0.77) | < 0.001 | 0.65 (0.51–0.84) | < 0.001 | 0.64 (0.51–0.80) | < 0.001 | 0.64 (0.50–0.83) |
0.001
|
Axilla LN operation (SLNB as ref.) | ||||||||
ALND | 1.89 (1.49–2.39) | < 0.001 | 2.22 (1.68–2.92) | < 0.001 | 1.17 (0.89–1.54) | 0.254 | 1.16 (0.85–1.60) | 0.347 |