SWT is distressing for patients and impairs their quality of life. There are few studies and no consensus in the literature concerning the impact of BC biology on SWT, particularly in each subtype. However, a randomized trial is not possible to study the SWT. We aimed to assess the impact of the SWT and the histological grade (HG) of tumor on DFS.
We retrospectively reviewed the data of Pts with invasive BC who received core needle biopsy (CNB) as diagnosis between January 2007 and June 2017. Pts who required neo-adjuvant chemotherapy were excluded. The primary analysis was a comparison of the DFS between patients who have SWT for 1 month or less (early group) and those who have them for longer than 1 month (late group). Propensity score matching in these groups was calculated based on the menopausal status, cT, cN, ER, PgR and HER2 status. Furthermore, we divided the Pts into 4 groups for the survival analysis as follows: the HH [high grade CNB/high grade surgical specimen (SS)], the LL (Low grade CNB/Low grade SS), LH (Low grade CNB/high grade SS) and the HL group (high grade CNB/low grade SS).
We analyzed the data of 1513 patients. Based on the propensity score, the early group and late group had 530 matched patients each. The median age was 62 years, cT1:58%, cT2:36%, cN0:75%, cN1;25%, ER(+) 82%, PgR(+) 68%, HER2(+):12% in both groups. The median diagnosis to curative SWT was 24.2 days in the early group and 46.7 days in the late group. A propensity score-matched model showed the significant difference in the DFS between the early group and the late group (5-year DFS rate, 92.9 vs. 86.6%; p = 0.0014 HR:1.98 1.30 to 3.08). Multivariate analysis revealed that the prognostic factors were significantly associated with cT (HR:2.02 95% CI 1.34 to 3.07), cN (HR:2.68 95% CI 1.78 to 4.04) and SWT (HR: 1.98, 95% CI, 1.30 to 3.08). ER, PgR and HER2 were not independent prognostic factors. The LH group for early group had a shorter DFS than the HL, HH and LL group (p = 0.0013). The HG for late group was not associated with survival.
The late group was significant worse in DFS compared with the early group. The histological up-grading of tumor for the early group was associated with worse survival.
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All authors have declared no conflicts of interest.