Unfavourable Clinicopathologic Features And Low Response Rate To Systemic Adjuvant Therapy: Results With Regard To Poor Survival In Young Chinese Breast Cancer Patients

Background and Objective The prognostic factors of young breast cancer patients (BCPs)are still controversial.This study is aimed at evaluating the prognosis of young BCPs by characteristics and treatment response. Materials and Methods The data on 2593 operable BCPs age≤50 years (y) who were treated in the Cancer Hospital of Fudan University, Shanghai, China between 1990 and 2004 were analyzed in this study.SPSS16.0 was used to analyzed the data. X2 test was administered to distinguish the difference in clinicopathological features.Life table and Kaplan-Meier curves were used to analyzed the survival status.Cox regression model was made to realize the multivariate analysis.The overall survival and recurrence/metastasis-free survival were compared.Results 782 patients(30.2%) were≤40y, and 1811(69.8%)were 41y-50y at their primary diagnosis.BCPs≤40y presented more unfavourable features than the 41y-50y BCPs(P<0.05).They were more likely to experience death (P<0.001)and recurrence/metastasis events (P<0.001) even when they underwent the same adjuvant therapy in parallel with their counterparts (P<0.05).In a multivariate analysis, age was an independent predictive factor for RFS (HR=0.26,95% CI=0.44-0.89, P=0.009)but not for OS (P>0.05).Higher TNM stage and chemotherapy, but not HER2/neu over-expression, were predictive factors for younger Chinese BCPs. Conclusions Characteristics of breast cancer are more aggressive in young Chinese BCPs.Their prognostic factors are obviously different from those of the elder group. Current therapy was not as effective for them. Background and Objective As the development of researches in chemokines receptors, the relationship of cancer and chemokines becomes much clearer. CXCR7 may have a great impact in the development and metastasis of breast cancer.Materials and Methods The data on 422 female patients suffered from breast diseases, age 25-88 years (y), who were treated in the Cancer Hospital of Fudan University, Shanghai, China between 2003 and 2006 were tested and analyzed in this study. Immunohistochemistry and RT-PCR were used to test the expression of CXCR7 in breast cancer. SPSS16.0 was used to analyzed the data. X2 test was administered to distinguish the difference in CXCR7 and clinicopathological features. Kaplan-Meier curves were used to analyzed the survival status. Cox regression model was made to realize the multivariate analysis. The overall survival and recurrence/ metastasis-free survival were compared.Results CXCR7 expressed both in beningn and malignant breast tumors. The positive percent was 100% (20/20) and 64.4% (252/391) respectively. The mRNA of CXCR7 showed diverse status in different cell lines; high expression in BT-474, MCF-7, SK-BR3 and MDA-MB-468; low expression in MDA-MB-231L but high in MDA-MB-231H. There was no significant relationship between CXCR7 expression and age, tumor size, axillary metastasis, vessel status or PS2 (P>0.05). CXCR7 positive was related to ER positive (P=0.02) and had a statistical trend in PR and HER2/neu expression (PR: P=0. 091, HER2/neu: P=0.078). Among the subgroup of grade III, CXCR7 positive patients had a better relapse/metastasis free survival (HR=0.44, P=0. 025, 95% CI=[0.19-1.03]). The HR for CXCR7 positive patients among all was 0.5 (P=0.049, 95% CI=0.25-0.99). Cnclusion CXCR7 expressed in both beningn and malignant diseases which may have a protective effect for prognosis and the conclusion was inconsistent with the present opinions. More studies and evidences should be provided to find out the exact role of CXCR7 in breast cancer.