ObjectiveBy comparing the epidemiological characteristics of the incidence and death of female breast cancer in China and the United States, the differences in prevention and screening strategies between China and the United States were analyzed to explore the prevention and control measures of female breast cancer in China. MethodsBased on the relevant data released by the Global Burden of Disease in 2020, the National Cancer Center of China, and the China Health Statistical Yearbook, the new cases and deaths of breast cancer in Chinese and American women in 2023 were estimated respectively, and the incidence, mortality and time trend of breast cancer in Chinese and American women were analyzed. ResultsIn China, 376 789 new cases of female breast cancer and 116 791 deaths were expected in 2023. In the United States, approximately 297 790 women were expected to be newly diagnosed with breast cancer in 2023, representing approximately 15.2% of new cancer cases. About 43 170 women died from breast cancer, accounting for about 7.1% of all cancer deaths. The incidence of breast cancer in women in the United States during the period 1975–2020 gradually increased and then stabilized; In contrast, the incidence of breast cancer among Chinese women increased year by year during the period 1990–2020. In recent years, the incidence and mortality rates of breast cancer in Chinese women had increased more than those in the United States, and there was a large difference between urban and rural areas in China. ConclusionsBoth China and the United States face a large burden of female breast cancer, and the characteristics of female breast cancer in China are similar to those in the United States. To reduce the burden of breast cancer in Chinese women, further efforts should be made in various aspects, such as strengthening breast cancer education, raising public health awareness, improving diet structure, cultivating healthy lifestyle, increasing screening efforts, and improving medical level.
ObjectiveTo explore the risk factors affecting sentinel lymph node (SLN) metastasis in patients with N0 early-stage breast cancer and establish a predictive model for SLN metastasis, so as to assist in the decision-making of axillary surgery in clinical practice. MethodsThe early breast cancer patients who underwent surgical treatment and SLN biopsy at the Affiliated Hospital of Southwest Medical University from September 2020 to December 2023 were selected as the study subjects. The univariate analysis and multivariable logistic regression analysis were adopted to analysis the relevant risk factors of SLN metastasis, then a predictive model evaluating the risk of SLN metastasis was constructed. The receiver operating characteristic (ROC) curve and the area under ROC curve (AUC) was used to assess the predictive performance of risk factors of SLN metastasis. ResultsA total of 351 patients with early breast cancer patients who met the inclusion criteria were collected, 136 of whom with SLN metastasis, the SLN metastasis rate was 38.7%. The results of the multivariate logistic regression analysis showed that the maximum tumor diameter >2.5 cm, ER positive, Ki-67 value >20%, and vascular invasion were the risk factors for SLN metastasis [maximum tumor diameter: OR(95%CI)=1.897(1.186, 3.034), P=0.008; ER positive: OR(95%CI)=2.721(1.491, 4.967), P=0.001; Ki-67 >20%: OR(95%CI)=1.825(1.125, 2.960), P=0.015; vascular invasion: OR(95%CI)=2.858(1.641, 4.976), P<0.001]. The AUC for the SLN metastasis by these four factors was 0.693, with a sensitivity and specificity of 70.59% and 57.21%, respectively. ConclusionsThe results from this study suggest that SLN biopsy is recommended to guide postoperative adjuvant treatment strategies for patients with cN0 early stage breast cancer with a maximum tumor diameter >2.5 cm, ER positivity, Ki-67 >20%, and vascular invasion. However, the predictive model constructed based on these four factors in this study has a general ability to distinguish the occurrence of SLN metastasis, then the reasons can be further analyzed in the future.