Supplementary materials: Breast-conserving surgery versus mastectomy for older women with triple-negative breast cancer: population-based study

These are peer-reviewed supplementary materials for the article 'Breast-conserving surgery versus mastectomy for older women with triple-negative breast cancer: population-based study' published in the Journal of Comparative Effectiveness Research.Supplementary figure 1Supplementary figure 2Supplementary figure 3Supplementary figure 4Supplementary Table S1: Cohort inclusion and exclusion criteriaSupplementary Table S2: Codes used to identity radiation, mastectomy, breast conserving surgerySupplementary Table S3: IPTW cox proportional hazards model predicting all-cause mortalitySupplementary Table S4: IPTW Fine-Gray Subdistribution hazard model for breast cancer deathSupplementary Table S5a: Multivariate Cox proportional hazards model predicting all-cause mortality after excluding those who survived for only one monthSupplementary Table S5b: Pairwise comparison - Multivariate Cox proportional hazards model predicting all-cause mortality after excluding those who survived for a month or lessSupplementary Table S6a: Fine-Gray Subdistribution hazard model for breast cancer death after excluding those who survived for a month or lessSupplementary Table S6b: Pairwise comparison - Fine-Gray Subdistribution hazard model for breast cancer death after excluding those who survived for a month or lessSupplementary Table S7a: Continuous age and tumor size broke further - Multivariate Cox proportional hazards model predicting all-cause mortalitySupplementary Table S7b: Pairwise comparison - Continuous age and tumor size broke further - Multivariate Cox proportional hazards model predicting all-cause mortalitySupplementary Table S8a: Continuous age and tumor size broke further - Fine-Gray Subdistribution hazard model for breast cancer deathSupplementary Table S8b: Pairwise comparison - Continuous age and tumor size broke further - Fine-Gray Subdistribution hazard model for breast cancer deathSupplementary Table S9: Chemotherapy receipt by treatmentSupplementary Table S10a: Multivariate Cox proportional hazards model predicting all-cause mortality including chemotherapy adjustmentSupplementary Table S10b: Pairwise Comparison - multivariate Cox proportional hazards model predicting all-cause mortality including chemotherapy adjustmentSupplementary Table S11a: Fine-Gray Subdistribution hazard model for breast cancer death including chemotherapy adjustmentSupplementary Table S11b: Pairwise comparison - Fine-Gray Subdistribution hazard model for breast cancer death including chemotherapy adjustmentSupplementary Table S12: Factors associated with receiving radiotherapy after breast conserving surgeryPurpose: To assess whether the poor prognosis of triple-negative breast cancer (TNBC) necessitates a more aggressive surgical approach. Methods: We examined the association of: breast-conserving surgery (BCS); BCS plus radiotherapy; mastectomy; and mastectomy plus radiotherapy with overall and breast cancer-specific survival of stage I–III TNBC patients aged 66 years and older. We used unweighted and inverse probability of treatment weighted Cox proportional hazards regression and the Fine and Gray sub-distribution model. Results: Among 4333 women, individuals who were selected for BCS, mastectomy or mastectomy plus radiotherapy had lower adjusted overall and breast cancer-specific survival compared with women who had BCS plus radiotherapy. Conclusion: In this population-based study, women with TNBC treated with BCS plus radiotherapy have a better prognosis than those treated with BCS, mastectomy or mastectomy plus radiotherapy. Given the poor prognosis of TNBC and selection bias inherent in observational studies, these findings should be confirmed in further studies such as randomized clinical trials.

本数据集为发表在《比较有效性研究杂志》上的文章《对于老年三阴性乳腺癌患者，保乳手术与乳房切除术的比较：基于人群的研究》的同行评审补充材料。包括补充图1、补充图2、补充图3、补充图4、补充表S1：队列纳入和排除标准、补充表S2：用于识别放疗、乳房切除术和保乳手术的编码、补充表S3：预测全因死亡率的IPTW cox比例风险模型、补充表S4：预测乳腺癌死亡的IPTW Fine-Gray亚分布风险模型、补充表S5a：排除仅存活一个月的患者后预测全因死亡率的多元Cox比例风险模型、补充表S5b：排除存活一个月或更短的患者后的成对比较 - 多元Cox比例风险模型预测全因死亡率、补充表S6a：排除存活一个月或更短的患者后乳腺癌死亡的Fine-Gray亚分布风险模型、补充表S6b：排除存活一个月或更短的患者后乳腺癌死亡的成对比较 - Fine-Gray亚分布风险模型、补充表S7a：进一步分析连续年龄和肿瘤大小 - 预测全因死亡率的多元Cox比例风险模型、补充表S7b：进一步分析连续年龄和肿瘤大小 - 成对比较 - 多元Cox比例风险模型预测全因死亡率、补充表S8a：进一步分析连续年龄和肿瘤大小 - Fine-Gray亚分布风险模型预测乳腺癌死亡、补充表S8b：进一步分析连续年龄和肿瘤大小 - 成对比较 - Fine-Gray亚分布风险模型预测乳腺癌死亡、补充表S9：化疗接受情况、补充表S10a：包括化疗调整的预测全因死亡率的多元Cox比例风险模型、补充表S10b：包括化疗调整的成对比较 - 多元Cox比例风险模型预测全因死亡率、补充表S11a：包括化疗调整的Fine-Gray亚分布风险模型预测乳腺癌死亡、补充表S11b：包括化疗调整的成对比较 - Fine-Gray亚分布风险模型预测乳腺癌死亡、补充表S12：接受保乳手术后放疗的因素。目的：评估三阴性乳腺癌（TNBC）不良预后是否需要更激进的手术方法。方法：我们研究了保乳手术（BCS）、BCS加放疗、乳房切除术和乳房切除术加放疗与66岁及以上I-III期TNBC患者的总生存率和乳腺癌特异生存率之间的关系。我们使用了未加权及逆概率治疗加权Cox比例风险回归和Fine & Gray亚分布模型。结果：在4333名女性中，选择BCS、乳房切除术或乳房切除术加放疗的患者与选择BCS加放疗的女性相比，调整后的总生存率和乳腺癌特异生存率较低。结论：在本基于人群的研究中，接受BCS加放疗治疗的TNBC女性预后优于接受BCS、乳房切除术或乳房切除术加放疗的女性。鉴于TNBC的不良预后和观察性研究中固有的选择偏差，这些发现应在进一步的研究中得以证实，如随机临床试验。