The Prognosis Of Molecular Subtypes In Invasive Ductal Breast Cancer

OBJECTIVE: To investigate diferent molecular subtypes of invasive ductal breast cancer for clinical prognosis and directing treatment.METHODS: From January 2000 to December 2008, 441 female primary invasive ductal breast cancer patients were retrospectively analyzed. The age was between 27-87, with a mean age of 49.2 years old. According to estrogen receptor(ER), progestogen receptor(PR) and epidermal growth factor receptor2(HER-2), total of 441 invasive ductal breast cancers were classified into four diferent subtypes: Luminal A, Luminal B, HER-2+, Triple- Negative. The factors such as distribution of molecular subtype, age, tumor size, lymph nodal status and histopathological type were observed. Kaplan-Meier survival analyses and COX proportional-hazards regression were used to identify the prognosis significance of the diferent molecular subtypes.RESULTS: Follow-up period was 3 ~ 96 months and median follow-up period was 31 months. Luminal A cases were the majority,189 cases (49.1%),the proportion of Luminal B was 70 cases (18.1%), the proportion of HER2-overexpressing was 53 cases (13.8%), the proportion of Triple-Negative was 73 cases (19%). Molecular subtypes had no relation with patients age, tumors size, lymph node metastasis status (P>0.05). Molecular subtypes had relation with histological grade, ER, PR, HER-2 status (P>0.05). Single factor survival analysis showed that disease free survival had relation with lymph node metastasis status, molecular subtypes, ER, PR, HER-2 status(P<0.05). There was a significant difference between disease free survival of different molecular subtypes(P<0.05). In different molecular subtypes, the group found that Luminal A had a good prognosis than the other three types, and the rest followed by Luminal B, Triple- Negative and HER-2+. Multivariate analysis revealed that the lymph node metastasis status, ER and HER-2 status associated with the prognosis of patients (P<0.05), and the hazard ratio of the lymph node metastasis status, ER and HER-2 status were 2.633 , 0.039 and 3.014.CONCLUSION: The molecular subtypes have relation with the clinical prognosis. The molecular subtypes represents more to the biological characteristics of breast cancer, it will critically aid clinical decision making at the level of individualization for most breast cancer.