Impact of radiotherapy on survival outcomes in elderly patients with T1-2n0-1M0 triple-negative breast cancer

Background The impact of radiotherapy on T1-2N0-1M0 triple-negative breast cancer (TNBC) in elderly patients remains unclear. This population-based study aims to investigate the influence of post-mastectomy radiotherapy (PMRT) on survival outcomes in elderly patients with T1-2N0-1M0TNBC. Methods A comprehensive screening of 63,766 TNBC patients diagnosed between 1975 and 2019 was conducted, resulting in the inclusion of 3582 triple-negative breast cancer patients with T1-2N0-1M0 after applying inclusion and exclusion criteria. Following 1:1 propensity score matching, the study comprised a radiotherapy group (1101) and a no-radiotherapy group (1101). Breast cancer-specific survival (BCSS) and overall survival (OS) were compared using univariate and multivariate Cox proportional hazard regression models. BCSS of TNBC patients was further analyzed using Kaplan-Meier survival curves, and stratified analyses were performed to identify factors influencing TNBC prognosis. Results Elderly TNBC patients receiving radiotherapy exhibited significantly higher BCSS compared to those without radiotherapy. Analysis of SEER database data and subgroup analyses through propensity score matching demonstrated improved BCSS across all selected subgroups, highlighting the positive impact of radiotherapy in elderly TNBC patients. These findings provide a comprehensive survival analysis; however, it is essential to acknowledge potential limitations and restrictions associated with radiotherapy. Conclusions Radiotherapy emerges as an independent prognostic and protective factor for survival in elderly patients with T1-2N0-1M0 triple-negative breast cancer. Significantly improving BCSS, radiotherapy is recommended as part of the treatment strategy for elderly TNBC patients.