Abstract: Objective To investigate the clinicopathological characteristics and prognostic factors of breast cancer ≤35 years old. Methods 171,799 patients with breast cancer from the national cancer institute surveillance, epidemiology, and results database （SEER, 2004-2010） were divided into a young group （4157 patients） and a non-young group （167,642 patients） ≤35 years old or >35 years old, and the clinicopathological differences between the two groups were analyzed by using calcine assay. Breast cancer OS and USES the Kaplan Meier method to calculate the median survival time for survival analysis, use Log-Rank test, single factor analysis of the results of single factor analysis statistically significant factors in the COX proportional hazards regression model with multiple factors analysis, get the independent risk factors affecting the prognosis of patients with breast cancer and the prognosis of patients with breast young independent factors. Results Young group compared to the young group was statistically significant in the clinical pathologic factors include： 35 or > 35 years old or less, staging, histological grading, N staging, molecular classification, whether to buy health insurance, including age, stage, histological grade, N staging, molecular classification, whether to buy health insurance was anindependent factor influence breast cancer head. In KM survival analysis, log-rank test showed that statistically significant factors suggested that patients with breast cancer ≤35 years old had a worse prognosis than those with > and 35 years old. In patients with breast cancer ≤35 years old, staging, histological grading, N staging, molecular typing, and whether to purchase medical insurance were independent factors influencing the prognosis of breast cancer. Conclusion In breast cancer ≤35 years old, higher stage, higher histological grade, more lymph node metastasis, more triple negative breast cancer or HER2 positive breast cancer, and more patients did not buy medical insurance. Age ≤35 years is an independent risk factor affecting the prognosis of breast cancer patients. In patients with breast cancer ≤35 years old, staging, histological grade, N staging, molecular typing, and whether to purchase medical insurance were independent factors influencing the prognosis of breast cancer.

Key words: young breast cancer, SEER database, prognostic factors

摘要： 目的 探讨≤35岁乳腺癌的临床病理特点及预后因素。方法 收集整理美国国立癌症研究所监测、流行病学和结果数据库SEER中2004~2010乳腺癌患者171 799例按照≤35岁或>35岁将患者分成年轻组（4157例）和非年轻组（167 642例）,利用卡法检验分析两组间的临床病理特征差异。采用 Kaplan Meier法计算乳腺癌相关OS和中位生存时间做生存分析,利用Log-Rank检验进行单因素分析,将单因素分析结果中有统计学意义的因素纳入COX比例风险回归模型进行多因素分析,得到影响乳腺癌患者预后的独立危险因素及年轻乳腺患者的预后的独立因素。结果 年轻组相比非年轻组检验中有统计学意义的临床病理因素包括：≤35岁或>35岁、分期、组织学分级、N分期、分子分型、是否购买医疗保险,其中年龄、分期、组织学分级、N分期、分子分型、是否购买医疗保险是影响乳腺癌脑独立影响因素。在KM生存分析当中,Log-Rank检验有统计学意义的因素提示≤35岁乳腺癌患者相比>35岁乳腺癌患者预后更差,在≤35岁乳腺癌患者中,分期、组织学分级、N分期、分子分型、是否购买医疗保险是乳腺癌预后独立影响因素。结论 ≤35岁乳腺癌中,分期更高、组织学分级更高、淋巴结转移个数更多、三阴乳腺癌或HER2阳乳腺癌占比例更多、更多患者没购买医疗保险。≤35岁是影响乳腺癌患者预后的独立危险因素。在≤35岁乳腺癌患者中,分期、组织学分级、N分期、分子分型、是否购买医疗保险是乳腺癌预后独立影响因素。

关键词: 年轻乳腺癌, SEER数据库, 预后因素