Systemic immune-inflammation index and ultrasonographic classification of breast imaging-reporting and data system predict outcomes of triple-negative breast cancer

Figures & data

Table 1 Baseline characteristics of 215 TNBC patients

Parameters	N=215	%
Age (years)
≤50	155	72
>50	60	28
Type of surgery
Breast-conserving surgery	34	16
Radical mastectomy	181	84
Tumor stage
pT1	45	21
pT2	125	58
pT3	39	18
pT4	6	3
Tumor histology
Ductal carcinoma	168	78
Lobular carcinoma	47	22
Histologic grade
I–II	138	64
III	77	36
Lympho-vascular invasion
Yes	30	14
No	185	86
Lymph node status
pN0	88	41
pN1	71	33
pN2	32	15
pN3	24	11
AJCC stage
I	30	14
II	114	53
III	71	33
Chemotherapy
Neoadjuvant chemotherapy	45	21
Adjuvant chemotherapy	170	79
Adjuvant radiotherapy
Yes	135	63
No	80	37
SII
≥624	108	50
<624	107	50

Abbreviations: AJCC, American Joint Committee on Cancer; TNBC, triple-negative breast cancer.

Table 2 Association between SII and clinicopathological parameters

Parameters	SII <624	SII ≥624	P
Age (years)
≤50	80	75	0.448
>50	27	33
Type of surgery
Breast-conserving surgery	18	16	0.712
Radical mastectomy	89	92
Tumor stage
pT1	31	14	0.004
pT2–4	76	94
Histologic grade
I–II	92	46	<0.001
III	15	62
Lymph node status
pN0	55	33	0.002
pN1–3	52	75
AJCC stage
I	20	10	0.051
II–III	87	98
Chemotherapy
Neoadjuvant chemotherapy	25	20	0.406
Adjuvant chemotherapy	82	88
Adjuvant radiotherapy
Yes	65	70	0.574
No	42	38

Abbreviations: AJCC, American Joint Committee on Cancer; SII, systemic immune-inflammation index.

Figure 1 DFS rates for 215 patients with TNBC as indicated by SII (P<0.001).

Abbreviations: DFS, disease-free survival; SII, systemic immune-inflammation index; TNBC, triple-negative breast cancer.

Figure 2 OS rates for 215 patients with TNBC as indicated by SII (P<0.001).

Abbreviations: OS, overall survival; SII, systemic immune-inflammation index; TNBC, triple-negative breast cancer.

Figure 3 DFS rates for 215 patients with TNBC as indicated by BI-RADS (P=0.001).

Abbreviations: BI-RADS, breast imaging-reporting and data system; DFS, disease-free survival; TNBC, triple-negative breast cancer.

Figure 4 OS rates for 215 patients with TNBC as indicated by BI-RADS (P<0.001).

Abbreviations: BI-RADS, breast imaging-reporting and data system; OS, overall survival; TNBC, triple-negative breast cancer.

Table 3 Univariable analysis for DFS and OS in TNBC

Variables	DFS			OS
	HR	95% CI	P	HR	95% CI	P
Age (years)
>50 vs ≤50	0.91	0.78–1.25	0.170	0.93	0.69–1.51	0.290
Type of surgery
Radical mastectomy vs breast conserving surgery	1.38	0.73–1.72	0.212	1.33	0.87–1.61	0.239
Tumor stage
pT2–4 vs pT1	2.23	1.61–3.15	0.005	2.93	2.16–3.82	<0.001
BI-RADS
5 vs 3–4	1.74	1.23–2.45	0.001	2.35	1.61–3.42	<0.001
Histologic grade
III vs I–II	3.05	2.64–4.25	<0.001	3.77	2.53–4.96	<0.001
Lympho-vascular invasion
Yes vs no	1.63	1.24–2.26	0.018	1.81	1.36–2.65	0.014
Lymph node status
pN1–3 vs pN0	2.56	1.13–2.72	0.003	3.05	1.61–4.16	0.002
Chemotherapy
Neoadjuvant vs adjuvant	1.10	0.62–1.62	0.426	1.11	0.72–1.61	0.704
Chemotherapy options
AC-T vs TP	1.22	0.84–1.39	0.391	1.15	0.89–1.31	0.514
Adjuvant radiotherapy
Yes vs no	1.02	0.59–1.36	0.510	1.07	0.65–1.52	0.685
SII
≥624 vs <624	3.16	1.82–4.02	<0.001	3.78	2.16–4.15	<0.001

Abbreviations: AC-T, anthracyclines + cyclophosphamide + paclitaxel; BI-RADS, breast imaging-reporting and data system; DFS, disease-free survival; OS, overall survival; SII, systemic immune-inflammation index; TNBC, triple-negative breast cancer; TP, docetaxel + carboplatin.

Table 4 Multivariable analysis for DFS and OS in TNBC

Variables	DFS			OS
	HR	95% CI	P	HR	95% CI	P
Tumor stage
pT2–4 vs pT1	2.25	1.52–2.81	0.014	2.06	1.45–3.56	0.002
BI-RADS
5 vs 3–4	1.59	1.12–2.26	0.009	2.18	1.481–3.22	<0.001
Lympho-vascular invasion
Yes vs no	1.53	0.93–1.84	0.144	1.52	1.06–1.86	0.039
Histologic grade
III vs I–II	3.03	1.61–3.48	0.010	2.66	1.88–3.25	0.004
Lymph node status
pN1–3 vs pN0	1.80	0.92–2.16	0.056	2.16	1.81–2.48	0.014
SII
≥624 vs <624	2.85	1.62–3.81	0.005	2.96	2.18–3.98	<0.001

Notes: P<0.008 was considered as statistically significant for multiple comparisons by using Holm–Bonferroni correction.

Abbreviations: BI-RADS, breast imaging-reporting and data system; DFS, disease-free survival; OS, overall survival; SII, systemic immune-inflammation index; TNBC, triple-negative breast cancer.