The Clinicopathologic Feature And Prognostic Analysis On 108 Cases Young Breast Cancer Patients

BackgroundThe breast is affected by a variety of hormonal regulation of exocrine organs,and it is the second sexual organs,too.Breast cancer is the most common malignant tumor in women′s dieases in the world.In Asian countries such as Korea and Hong Kong in China,the morbidity is increased by 3.6%~4.9% year by year and appears younger tendency.Breast cancer becomes the first female malignant tumor in our country.Now,the definition of young breast cancer is no unification in the world.Referring to literature in recent years,the age of young patients is ≤30,≤35,≤40 and so on.The research defines the age≤35 young patiens as young breast cancer,which is more aggressive and worse prognosis than the old,and the young patients have the occupancy of 5.5%~13% in the corresponding period.The hazards includes earlier menarche,elder age with first pregnancy,less production,oral contraceptives in young age,contraceptives with a long time.The main hazard factor is positive family history,which is provided with BRCA1/2 gene mutation.They have more disadvantageous pathological and biological characteristic.Clinically we find the patients with the same in the histological type and pathological stage are much more different in the clinical feature,therapeutic response and prognosis,the reason is the different subtypes among the breast cancer patients.According to ER、PR and Her-2 based on the gene expression,Perou put forword the inherent molecules about the breast cancer.It is simplified as now the subtypes as the new sign Ki-67 was introduced.Nowadays the molecular biological technique is developing fast,the breast cancer subtypes is concerned by more and more tumor scholars with the promulgate by Human Genome Project(HGP).The peak age of the patient group is 40 to 50 in our country,young patients are the special group,which lead to bad prognosis.However,young patients have the demand on beauty,childbearing and so on,they make the doctors pay high attention to them.It is controversial toward the prognosis of different molecular subtypes.The reseach was enrolled clinicopathologic features of 830 patients,we divided into young group(108 ones)and senior group(722 ones),we had them a comparison and analysis so we can understand the clinicopathologic feature.We had a retrospective analysis on 108 young patients,so we can guide the clinical treatment individual.Objective1.To have a better understanding of clinicopathological characteristic.To explore the difference of clinical feature of young patients and senior ones.2.To make the clinicopathological characteristics such as tumor size,lymph node metastasis,age,molecular subtypes adjuvant chemotherapy,surgical methods,endocrine therapy,radiotherapy and a prognostic effect analysis of molecular subtype on young patients.So we can improve diagnosis and treatment level,guide the clinical treatment,then the patient cannot lack of care nor be over-treated,the prognosis will be improved with high limit.Method1.Clinical data of breast cancer patients from the Third Affiliated Hospital of Zhengzhou University were enrolled between Jan.2007 and Oct.2012,108 young patients included and 722 senior ones,the clinicopathological characteristics statistical analysis using SPSS 17.0 statistical software.The clinical and pathological features are statistical data using the Chi-square test,P<0.05 is significant.2.According to clinical data of 108 young breast cancer patients(≤35years)included from the Third Affiliated Hospital of Zhengzhou University were enrolled between Jan.2007 and Oct.2012.Univariate analysis for the Log-rank and multivariate Cox proportional hazard regression analysis were used,statistically significant(P<0.05).We draw the curves through Kaplan-Meier method.The young patients prognosis was a retrospective analysis.Result1.There were no significant differnce(P>0.05)between two group with metastic axillary lymph node and the subtypes,while there were significant difference(P<0.05)with tumor size,delayed diagnosis time and the surgery.2.Univariate analysis of prognostic factors of Log-rank showed that there were no significant difference(P>0.05,χ2=2.381,1.958,0.027,2.612)between recurrence with chemotherapy,radiotherapy,endocrine therapy and the subtypes,while there were significant difference(P<0.05,χ2=9.612,12.099,51.345,5.928)with tumor size,age,metastic axillary lymph node,surgery.3.We draw the disease-free survivalcurves through Kaplan-Meier method.Five-year disease-free survival(DFS)rate of young patients was 64.7%,Five-year survival rate of young patients was 78.9%.There were no statistically significant(P>0.05)between five-year disease-free through pairwise comparison of five-year DFS.There were no statistically significant(P>0.05)between five-year survival rate through pairwise comparison.4.Multivariate Cox proportional hazards regression analysis indicated that tumor size(RR,5.367;95%CI,1.519 to 19.822;P=0.009)and lymph node metastasis(RR,5.655;95%CI,2.939 to 10.884;P<0.001)were independent prognostic factors of disease recurrence.Conclusion1.The young patients had a more delayed diagnosis time and bigger tumor size compared with senior ones.Young patients need pay attention and attach importance to the screening and therapy of breast cancer more in the early time.2.Tumor size and lymph node metastasis were important prognostic factors on young breast cancer patients.