Risk factors of recurrence and metastasis in patients with hormonal receptor-positive and HER-2-negative T1-3N0M0 invasive breast cancer

doi:10.3877/cma.j.issn.1674-0807.2022.03.002

Abstract

Abstract:

Objective

To analyze the risk factors of recurrence and metastasis in female patients with hormone receptor(HR)-positive/HER-2-negative T_1-3N₀M₀ invasive breast cancer.

Methods

The clinicopathological data of 1 064 patients with HR-positive/HER-2-negative T_1-3N₀M₀ invasive breast cancer in the Xijing Hospital of Air Force Medical University from January 1, 2008 to December 31, 2017 were retrospectively analyzed. Kaplan-Meier method was used to make survival analysis. The Cox proportional risk regression model was used to explore independent prognostic factors for recurrence and metastasis. Receiver operating characteristic (ROC) curve was drawn and area under the curve (AUC) was calculated to assess the accuracy of independent factors in predicting the recurrence-free survival.

Results

The 5-year and 10-year recurrence-free survival in these patients were 93.90% (95%CI: 92.30%-95.40%) and 87.10% (95%CI: 84.00%-90.20%), respectively. Univariate Cox proportional risk regression analysis showed that endocrine therapy, maximum diameter of the tumor and Ki-67 expression were affecting factors for recurrence and metastasis (HR=5.39, 95%CI: 3.25-8.94, P<0.001; HR=1.28, 95%CI: 1.11-1.48, P=0.001; HR=1.92, 95%CI: 1.24-2.96, P=0.003). Multivariate Cox proportional risk regression analysis showed that endocrine therapy, maximum diameter of the tumor and Ki-67 expression were independent prognostic factors of recurrence and metastasis (HR=4.76, 95%CI: 2.83-8.02, P<0.001; HR=1.17, 95%CI: 1.01-1.37, P=0.043; HR=1.79, 95%CI: 1.16-2.76, P=0.009). The risk of postoperative recurrence and metastasis in patients who did not receive endocrine therapy was 4.76 times as high as that in patients with endocrine therapy; the risk of postoperative recurrence and metastasis in patients with Ki-67 level >20% was 1.79 times as high as that in patients with Ki-67 level ≤20%. The AUC indicated that the above-mentioned three variables had high accuracy in predicting postoperative recurrence-free survival in HR-positive/HER-2-negative T_1-3N₀M₀ invasive breast cancer. The 3-year, 5-year, and 10-year AUC was 0.73 (95%CI: 0.67-0.80, P<0.001), 0.72 (95%CI: 0.66-0.78, P<0.001), 0.68 (95%CI: 0.62-0.75, P<0.001), respectively.

Conclusion

In patients with HR-positive/ HER-2-negative T_1-3N₀M₀ invasivebreast cancer, the combination of these three factors (endocrine therapy, maximum diameter of the tumor and Ki-67 expression)can predict postoperative recurrence-free survival and provide guidance for individualized treatment.

Key words: Breast neoplasms, Receptors, estrogen, Humans, Receptor, epidermal growth factor, Recurrence

Lili Guo, Niuniu Hou, Jingjing Xiao, Zhe Wang, Yaping Wang, Jun Yi, Rui Ling. Risk factors of recurrence and metastasis in patients with hormonal receptor-positive and HER-2-negative T_1-3N₀M₀ invasive breast cancer[J]. Chinese Journal of Breast Disease(Electronic Edition), 2022, 16(03): 138-146.

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References 42

[1]	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
[2]	Cao W, Chen HD, Yu YW, et al. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020[J]. Chin Med J (Engl), 2021, 134(7): 783-791.
[3]	Goldhirsch A, Wood WC, Coates AS, et al. Strategies for subtypes—dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011[J]. Ann Oncol, 2011, 22(8): 1736-1747.
[4]	Eroles P, Bosch A, Pérez-Fidalgo JA, et al. Molecular biology in breast cancer: intrinsic subtypes and signaling pathways[J]. Cancer Treat Rev, 2012, 38(6): 698-707.
[5]	Howlader N, Altekruse SF, Li CI, et al. US incidence of breast cancer subtypes defined by joint hormone receptor and HER-2 status[J]. J Natl Cancer Inst, 2014, 106(5): dju055.
[6]	van Maaren MC, de Munck L, Strobbe LJA, et al. Ten-year recurrence rates for breast cancer subtypes in the Netherlands: A large population-based study[J]. Int J Cancer，2019，144(2)：263-272.
[7]	Sparano JA, Zhao F, Martino S, et al. Long-term follow-up of the E1199 phase III trial evaluating the role of taxane and schedule in operable breast cancer[J]. J Clin Oncol，2015，33(21)：2353-2360.
[8]	Chen J, Wu X, Christos PJ, et al. Practice patterns and outcomes for patients with node-negative hormone receptor-positive breast cancer and intermediate 21-gene Recurrence Scores[J]. Breast Cancer Res, 2018, 20(1)：26.
[9]	Vaz-Luis I, Ottesen RA, Hughes ME, et al. Outcomes by tumor subtype and treatment pattern in women with small, node-negative breast cancer: a multi-institutional study[J]. J Clin Oncol, 2014, 32(20): 2142-2150.
[10]	Thürlimann B, Price KN, Gelber RD, et al. Is chemotherapy necessary for premenopausal women with lower-risk node-positive, endocrine responsive breast cancer? 10-year update of International Breast Cancer Study Group Trial 11-93[J]. Breast Cancer Res Treat, 2009, 113(1): 137-144.
[11]	Sparano JA, Gray RJ, Makower DF, et al. Adjuvant chemotherapy guided by a 21-Gene Expression Assay in breast cancer[J]. N Engl J Med, 2018, 379(2): 111-121.
[12]	Kalinsky K, Barlow WE, Gralow JR, et al. 21-Gene Assay to inform chemotherapy benefit in node-positive breast cancer[J]. N Engl J Med, 2021, 385(25): 2336-2347.
[13]	Fisher B, Dignam J, Wolmark N, et al. Tamoxifen and chemotherapy for lymph node-negative, estrogen receptor-positive breast cancer [J]. J Natl Cancer Inst, 1997, 89(22): 1673-1682.
[14]	Albanell J, Svedman C, Gligorov J, et al. Pooled analysis of prospective European studies assessing the impact of using the 21-gene Recurrence Score assay on clinical decision making in women with oestrogen receptor-positive, human epidermal growth factor receptor 2-negative early-stage breast cancer[J]. Eur J Cancer, 2016, 66：104-113.
[15]	Orucevic A, Heidel RE, Bell JL. Utilization and impact of 21-gene recurrence score assay for breast cancer in clinical practice across the United States: lessons learned from the 2010 to 2012 National Cancer Data Base analysis[J]. Breast Cancer Res Treat, 2016, 157(3): 427-435.
[16]	Nguyen TTA, Postlewait LM, Zhang C, et al. Utility of Oncotype DX score in clinical management for T1 estrogen receptor positive, HER2 negative, and lymph node negative breast cancer[J]. Breast Cancer Res Treat, 2022，192(3)：509-516.
[17]	Koscielny S, Tubiana M, Lê MG, et al. Breast cancer: relationshipbetween the size of the primary tumour and the probability of metastatic dissemination[J]. Br J Cancer, 1984, 49(6)：709-715.
[18]	Fisher B, Slack NH. Number of lymph nodes examined and the prognosis of breast carcinoma [J]. Surg Gynecol Obstet, 1970, 131(1)：79-88.
[19]	Mueller CB, Ames F, Anderson GD. Breast cancer in 3 558 women: age as a significant determinant in the rate of dying and causes of death[J]. Surgery, 1978, 83(2): 123-132.
[20]	Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up[J]. Histopathology, 1991, 19(5)：403-410.
[21]	Nguyen PL, Taghian AG, Katz MS, et al. Breast cancer subtype approximated by estrogen receptor, progesterone receptor, and HER-2 is associated with local and distant recurrence after breast-conserving therapy[J]. J Clin Oncol, 2008, 26(14): 2373-2378.
[22]	Engelhardt EG, Garvelink MM, de Haes JH, et al. Predicting and communicating the risk of recurrence and death in women with early-stage breast cancer: a systematic review of risk prediction models[J]. J Clin Oncol, 2014, 32(3): 238-250.
[23]	Amin MB, Edge S, Greene F, et al. AJCC cancer staging manual[M]. 8th ed. New York: Springer, 2016：589-628.
[24]	Rosen PR, Groshen S, Saigo PE, et al. A long-term follow-up study of survival in stage Ⅰ (T₁N₀M₀) and stage Ⅱ (T₁N₁M₀) breast carcinoma[J]. J Clin Oncol, 1989, 7(3): 355-366.
[25]	Fisher B, Jeong JH, Bryant J, et al. Treatment of lymph-node-negative, oestrogen-receptor-positive breast cancer: long-term findings from National Surgical Adjuvant Breast and Bowel Project randomised clinical trials[J]. Lancet, 2004, 364(9437): 858-868.
[26]	Allison KH, Hammond MEH, Dowsett M, et al. Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP guideline update[J]. J Clin Oncol, 2020, 38(12): 1346-1366.
[27]	Wolff AC, Hammond ME, Hicks DG, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update[J]. J Clin Oncol, 2013, 31(31)：3997-4013.
[28]	Goldhirsch A, Winer EP, Coates AS, et al. Personalizing the treatment of women with early breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013[J]. Ann Oncol, 2013, 24(9): 2206-2223.
[29]	Metzger-Filho O, Sun Z, Viale G, et al. Patterns of Recurrence and outcome according to breast cancer subtypes in lymph node-negative disease: results from international breast cancer study group trials Ⅷ and Ⅸ [J]. J Clin Oncol, 2013, 31(25): 3083-3090.
[30]	何英剑，范照青，李金锋，等. 腋窝淋巴结状态对不同类型浸润性乳腺癌预后的影响[J]. 中华医学杂志，2021, 101(30): 2382-2386.
[31]	Penault-Llorca F, Radosevic-Robin N. Ki67 assessment in breast cancer: an update[J]. Pathology, 2017, 49(2): 166-171.
[32]	Ignatiadis M, Azim HA Jr, Desmedt C, et al. The genomic Grade assay compared with Ki67 to determine risk of distant breast cancer recurrence[J]. JAMA Oncol, 2016, 2(2): 217-224.
[33]	马琴，厚玉瑾，高旭彤，等. HR+/HER2-乳腺癌患者Ki-67临界值的确定及表达对早期复发转移的影[J]. 天津医药，2021, 49(12): 1319-1323.
[34]	Regan MM, Francis PA, Pagani O, et al. Absolute benefit of adjuvant endocrine therapies for premenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative early breast cancer: TEXT and SOFT trials[J]. J Clin Oncol, 2016, 34(19): 2221-2231.
[35]	Pagani O, Francis PA, Fleming GF, et al. Absolute improvements in freedom from distant recurrence to tailor adjuvant endocrine therapies for premenopausal women: results from TEXT and SOFT[J]. J Clin Oncol, 2020, 38(12): 1293-1303.
[36]	Gradishar WJ, Moran MS, Abraham J, et al. NCCN guidelines^® insights: breast cancer, version 4.2021 [J]. J Natl Compr Canc Netw, 2021, 19(5): 484-493.
[37]	Paik S, Shak S, Tang G, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer[J]. N Engl J Med, 2004, 351(27): 2817-2826.
[38]	Lee SB, Kim J, Sohn G, et al. A nomogram for predicting the Oncotype DX recurrence score in women with T_1-3N_0-1miM₀ hormone receptor positive, human epidermal growth factor 2 (HER-2) negative breast cancer[J]. Cancer Res Treat, 2019, 51(3): 1073-1085.
[39]	Klein ME, Dabbs DJ, Shuai Y, et al. Prediction of the Oncotype DX recurrence score: use of pathology-generated equations derived by linear regression analysis[J]. Mod Pathol, 2013, 26(5): 658-664.
[40]	Kraus JA, Dabbs DJ, Beriwal S, et al. Semi-quantitative immunohistochemical assay versus oncotype DX(^®) qRT-PCR assay for estrogen and progesterone receptors: an independent quality assurance study [J]. Mod Pathol, 2012, 25(6): 869-876.
[41]	Cuzick J, Dowsett M, Pineda S, et al. Prognostic value of a combined estrogen receptor, progesterone receptor, Ki-67, and human epidermal growth factor receptor 2 immunohistochemical score and comparison with the genomic health recurrence score in early breast cancer [J]. J Clin Oncol, 2011, 29(32): 4273-4278.
[42]	罗凤，陈霞．乳腺癌患者辅助内分泌治疗依从性现状及对策的研究进展[J/CD]．中华乳腺病杂志(电子版), 2020, 14(2): 116-119.

因素	变量	赋值
确诊时年龄	X₁	≤40＝0，41~50岁＝1，51~60岁＝2，61~70岁＝3，>70岁＝4
确诊时月经状态	X₂	绝经后＝0，绝经前＝1
肿瘤最大径	X₄	连续变量
肿瘤位置	X3	左侧＝0，右侧＝1
组织学类型	X₅	预后良好型^a＝0，IDC/NST＝1，浸润性小叶癌＝2，其他^b＝3
组织学分级	X₆	1级＝0，2级＝1，3级＝2
雌激素受体状态	X₇	阳性＝0,阴性＝1
孕激素受体状态	X₈	阳性＝0,阴性＝1
HR状态	X₉	ER(+)、PR(+)＝0，ER(+)、PR(-)＝1，ER(-)、PR(+)＝2
Ki-67水平	X₁₀	≤20%＝0，>20%＝1
脉管癌栓	X₁₁	阴性＝0，阳性＝1
镜下软组织侵犯	X₁₂	阴性＝0，阳性＝1
术中切缘状态	X₁₃	阴性＝0，阳性＝1
手术方式	X₁₄	乳房切除手术＝0，保留乳房手术＝1
内分泌治疗	X₁₅	是＝0，否＝1
化疗	X₁₆	是＝0，否＝1
放射治疗	X₁₇	是＝0，否＝1
生存状态	Y	无复发、转移＝0，复发、转移＝1

因素	变量	赋值
确诊时年龄	X₁	≤40＝0，41~50岁＝1，51~60岁＝2，61~70岁＝3，>70岁＝4
确诊时月经状态	X₂	绝经后＝0，绝经前＝1
肿瘤最大径	X₄	连续变量
肿瘤位置	X3	左侧＝0，右侧＝1
组织学类型	X₅	预后良好型^a＝0，IDC/NST＝1，浸润性小叶癌＝2，其他^b＝3
组织学分级	X₆	1级＝0，2级＝1，3级＝2
雌激素受体状态	X₇	阳性＝0,阴性＝1
孕激素受体状态	X₈	阳性＝0,阴性＝1
HR状态	X₉	ER(+)、PR(+)＝0，ER(+)、PR(-)＝1，ER(-)、PR(+)＝2
Ki-67水平	X₁₀	≤20%＝0，>20%＝1
脉管癌栓	X₁₁	阴性＝0，阳性＝1
镜下软组织侵犯	X₁₂	阴性＝0，阳性＝1
术中切缘状态	X₁₃	阴性＝0，阳性＝1
手术方式	X₁₄	乳房切除手术＝0，保留乳房手术＝1
内分泌治疗	X₁₅	是＝0，否＝1
化疗	X₁₆	是＝0，否＝1
放射治疗	X₁₇	是＝0，否＝1
生存状态	Y	无复发、转移＝0，复发、转移＝1

临床特征		无复发、转移(n＝982)	复发、转移(n＝82)	检验值	P值
确诊时年龄
	≤40岁	160(16.3)	19(23.2)	Z＝-0.391	0.696
	41~50岁	406(41.3)	27(32.9)
	51~60岁	229(23.3)	18(22.0)
	61~70岁	133(13.5)	16(19.5)
	>70岁	54(5.5)	2(2.4)
确诊时月经状态
	绝经后	390(39.7)	36(43.9)	χ²＝0.553	0.457
	绝经前	592(60.3)	46(56.1)	χ²＝0.553	0.457
肿瘤最大径[cm，M(P₂₅，P₇₅)]
		1.6(1.2，2.1)	1.9(1.5，2.5)	Z＝-2.925	0.003
肿瘤位置
	左侧	485(49.4)	35(42.7)	χ²＝1.362	0.243
	右侧	497(50.6)	47(57.3)	χ²＝1.362	0.243
组织学类型
	预后良好型^a	72(7.3)	3(3.7)	χ²＝1.617	0.656
	IDC/NST	822(83.7)	72(87.8)
	浸润性小叶癌	37(3.8)	3(3.7)
	其他^b	51(5.2)	4(4.9)
组织学分级
	1级	129(13.1)	8(9.8)	Z＝-1.153	0.249
	2级	772(78.6)	65(79.3)
	3级	81(8.2)	9(11.0)
雌激素受体状态
	阳性	965(98.3)	78(95.1)		0.072^c
	阴性	17(1.7)	4(4.9)		0.072^c
孕激素受体状态
	阳性	867(88.3)	74(90.2)	χ²＝0.283	0.595
	阴性	115(11.7)	8(9.8)	χ²＝0.283	0.595
HR状态
	ER(+)、PR(-)	115(11.7)	8(9.8)	χ²＝4.060	0.131
	ER(+)、PR(+)	850(86.6)	70(85.4)
	ER(-)、PR(+)	17(1.7)	4(4.9)
Ki-67水平
	≤20%	657(66.9)	43(52.4)	χ²＝7.036	0.008
	>20%	325(33.1)	39(47.6)	χ²＝7.036	0.008
脉管癌栓
	阴性	970(98.8)	80(97.6)		0.294^c
	阳性	12(1.2)	2(2.4)		0.294^c
镜下软组织侵犯
	阴性	946(96.3)	79(96.3)		1.000^c
	阳性	36(3.7)	3(3.7)		1.000^c
术中切缘状态
	阴性	965(98.3)	80(97.6)		0.653^c
	阳性	17(1.7)	2(2.4)		0.653^c
手术方式
	乳房切除手术	644(65.6)	58(70.7)	χ²＝0.895	0.344
	保留乳房手术	338(34.4)	24(29.3)	χ²＝0.895	0.344
内分泌治疗
	是	937(95.4)	62(75.6)	χ²＝51.768	<0.001
	否	45(4.6)	20(24.4)	χ²＝51.768	<0.001
化疗
	是	618(62.9)	62(75.6)	χ²＝5.273	0.022
	否	364(37.1)	20(24.4)	χ²＝5.273	0.022
放射治疗
	是	296(30.1)	21(25.6)	χ²＝0.743	0.389
	否	686(69.9)	61(74.4)	χ²＝0.743	0.389

临床特征		无复发、转移(n＝982)	复发、转移(n＝82)	检验值	P值
确诊时年龄
	≤40岁	160(16.3)	19(23.2)	Z＝-0.391	0.696
	41~50岁	406(41.3)	27(32.9)
	51~60岁	229(23.3)	18(22.0)
	61~70岁	133(13.5)	16(19.5)
	>70岁	54(5.5)	2(2.4)
确诊时月经状态
	绝经后	390(39.7)	36(43.9)	χ²＝0.553	0.457
	绝经前	592(60.3)	46(56.1)	χ²＝0.553	0.457
肿瘤最大径[cm，M(P₂₅，P₇₅)]
		1.6(1.2，2.1)	1.9(1.5，2.5)	Z＝-2.925	0.003
肿瘤位置
	左侧	485(49.4)	35(42.7)	χ²＝1.362	0.243
	右侧	497(50.6)	47(57.3)	χ²＝1.362	0.243
组织学类型
	预后良好型^a	72(7.3)	3(3.7)	χ²＝1.617	0.656
	IDC/NST	822(83.7)	72(87.8)
	浸润性小叶癌	37(3.8)	3(3.7)
	其他^b	51(5.2)	4(4.9)
组织学分级
	1级	129(13.1)	8(9.8)	Z＝-1.153	0.249
	2级	772(78.6)	65(79.3)
	3级	81(8.2)	9(11.0)
雌激素受体状态
	阳性	965(98.3)	78(95.1)		0.072^c
	阴性	17(1.7)	4(4.9)		0.072^c
孕激素受体状态
	阳性	867(88.3)	74(90.2)	χ²＝0.283	0.595
	阴性	115(11.7)	8(9.8)	χ²＝0.283	0.595
HR状态
	ER(+)、PR(-)	115(11.7)	8(9.8)	χ²＝4.060	0.131
	ER(+)、PR(+)	850(86.6)	70(85.4)
	ER(-)、PR(+)	17(1.7)	4(4.9)
Ki-67水平
	≤20%	657(66.9)	43(52.4)	χ²＝7.036	0.008
	>20%	325(33.1)	39(47.6)	χ²＝7.036	0.008
脉管癌栓
	阴性	970(98.8)	80(97.6)		0.294^c
	阳性	12(1.2)	2(2.4)		0.294^c
镜下软组织侵犯
	阴性	946(96.3)	79(96.3)		1.000^c
	阳性	36(3.7)	3(3.7)		1.000^c
术中切缘状态
	阴性	965(98.3)	80(97.6)		0.653^c
	阳性	17(1.7)	2(2.4)		0.653^c
手术方式
	乳房切除手术	644(65.6)	58(70.7)	χ²＝0.895	0.344
	保留乳房手术	338(34.4)	24(29.3)	χ²＝0.895	0.344
内分泌治疗
	是	937(95.4)	62(75.6)	χ²＝51.768	<0.001
	否	45(4.6)	20(24.4)	χ²＝51.768	<0.001
化疗
	是	618(62.9)	62(75.6)	χ²＝5.273	0.022
	否	364(37.1)	20(24.4)	χ²＝5.273	0.022
放射治疗
	是	296(30.1)	21(25.6)	χ²＝0.743	0.389
	否	686(69.9)	61(74.4)	χ²＝0.743	0.389

因素		HR值	95%CI	P值
确诊时年龄
	≤40岁	1.00
	41~50岁	0.59	0.33~1.06	0.080
	51~60岁	0.70	0.37~1.33	0.278
	61~70岁	1.15	0.59~2.24	0.675
	>70岁	0.44	0.10~1.89	0.270
确诊时月经状态
	绝经后	1.00
	绝经前	0.79	0.51~1.23	0.296
肿瘤最大径		1.28	1.11~1.48	0.001
肿瘤位置
	左侧	1.00
	右侧	1.33	0.86~2.06	0.204
组织学类型
	预后良好型^a	1.00
	IDC/NST	2.05	0.64~6.50	0.224
	浸润性小叶癌	1.83	0.37~9.05	0.461
	其他^b	2.11	0.47~9.43	0.328
组织学分级
	1级	1.00
	2级	1.24	0.560~2.59	0.561
	3级	1.60	0.62~4.16	0.331
雌激素受体状态
	阳性	1.00
	阴性	2.49	0.91~6.82	0.075
孕激素受体状态
	阳性	1.00
	阴性	0.74	0.36~1.54	0.427
HR状态
	ER(+)、PR(-)	1.00
	ER(+)、PR(+)	1.30	0.62~2.70	0.482
	ER(-)、PR(+)	3.14	0.95~10.45	0.061
Ki-67水平
	≤20%	1.00
	>20%	1.92	1.24~2.96	0.003
脉管癌栓
	阴性	1.00
	阳性	2.35	0.58~9.58	0.232
镜下软组织侵犯
	阴性	1.00
	阳性	0.85	0.28~2.77	0.819
术中切缘状态
	阴性	1.00
	阳性	2.14	0.52~8.77	0.288
手术方式
	乳房切除手术	1.00
	保留乳房手术	0.93	0.58~1.51	0.779
内分泌治疗
	是	1.00
	否	5.39	3.25~8.94	<0.001
化疗
	是	1.00
	否	0.76	0.46~1.27	0.298
放射治疗
	是	1.00
	否	1.16	0.71~1.91	0.555

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Risk factors of recurrence and metastasis in patients with hormonal receptor-positive and HER-2-negative T_1-3N₀M₀ invasive breast cancer

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