Download This Paper
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
Natural History of Breast Cancer: Reanalyze Nodal Stage and Oestrogen Receptor Status Affecting the Progression of Breast Cancer from SEER Database
25 Pages Posted: 17 Sep 2020
More...Abstract
Background: Characterizing the evolutionary history of breast cancer, including the role of primary tumor and axillary lymph nodes in metastasis progression and the difference metastatic potential and growth rate of metastatic lesions between different subtypes, can provide a rational basis for effective treatments.
Methods: We employed data from the Surveillance, Epidemiology, and End Results (SEER) database to perform survival analysis and modelling to estimate breast cancer progression in both untreated and treated patients.
Findings: We found that while tumour size was a significant prognostic factor in both untreated and treated patients, the prognostic value of nodal status was only significant in patients who received locoregional treatment and systemic treatment. And our modelling results of breast cancer progression indicate that in the modern era the predictive value of nodal status should be further emphasized. The cumulative 20-year breast cancer-specific death (BCSD) rates were significantly correlated to increased T stage and N stage, meanwhile, although similar BCSD was seen in ER-positive and ER-negative patients given the same anatomy stage, ER-negative patients had much higher BCSD rates in the first 5 and 10 years.
Interpretation: Our study showed that the metastatic potential was mainly determined by anatomic staging while the growth rate of metastatic lesion was greatly affected by molecular traits of breast cancer.
Funding Statement: This work has been funded by the Natural Science Foundation of Beijing (grant no. 7202212) and the National Key Research and Development Plan, Precision Medicine Research project (grant no. 2016YFC0901302).
Declaration of Interests: The authors declare no potential conflicts of interest.
Keywords: Breast Cancer, Natural History, Anatomic Staging, Mathematical Modelling, Metastatic Potential
Suggested Citation: Suggested Citation