Abstract: Objective To explore the impact of clinical treatment decisions on the long-term survival of different molecular subtypes of locally advanced breast cancer(LABC),and to promote the development of more effective and individualized treatment regimens for LABC.Methods The cases of LABC diagnosed by pathology from 2010 to 2015 were searched in the database.Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated by plotting Kaplan-Meier curves.The log rank test (Mantel-Cox) was used to analyze the difference between the groups,and the benefit population of LABC was determined after for age,TNM stage,grade,treatment methods.Results The 5-year OS and BCSS were 77.43% and 84.34% in breast-conserving,and 68.03% and 76.90% in mastectomy,respectively.The 5-year OS and BCSS of Luminal A LABC were 79.91% and 87.23% in breast-conserving,and 71.78% and 81.16% in mastectomy,respectively.The 5-year OS and BCSS of Luminal B LABC were 79.30% and 83.14% in breast-conserving,and were 70.37% and 76.92% in mastectomy,respectively.The 5-year OS and BCSS of triple-negative LABC were 60.77% and 68.13% in breast-conserving,and those of mastectomy were 47.13% and 55.94%,respectively.The 5-year OS and BCSS of HER2 positive were 75.42%,82.05% in breast-conserving,and were 67.05% and 75.01% in mastectomy,respectively;The 5-year OS and BCSS of triple-positive LABC were 86.12% and 91.63% in breast-conserving,and 74.54% and 82.56% in mastectomy,respectively.The 5-year OS and BCSS of well differentiated and N0 triple-positive LABC patients with chemotherapy were 88.24% and 76.91%,and those of patients without chmotherapy were 88.24% and 90.91%,respectively (BCSS:P=0.812;OS:P=0.311).Conclusion In the selective population,OS and BCSS of patients with LABC undergoing breast conserving surgery were significantly better than those of mastectomy.When OS and BCSS were compared for different molecular types and stages of LABC, breast-conserving surgery was still superior to total mastectomy.LABC could be considered for highly differentiated,N0 stage Triple positive without chemotherapy.

Key words: locally advanced breast cancer； molecular subtypes； breast cancer-specific survival； overall survival； survival analysis