| Background:Nowadays,breast cancer accounts for the highest morbidity and mortality among all cancers in female globally.According to the characteristics of molecular biology,breast cancer can be divided into hormone receptor positive type(Luminal A/B type),Her-2 overexpression type and triple negative type.Currtlly,the main treatment methods for breast cancer include surgery combined with chemotherapy,radiotherapy,molecular targeted therapy,endocrine therapy and other comprehensive treatment.Preoperative treatment was generally used in locally advanced breast cancer,and now it has been used in operable patients usually.Neoadjuvant chemotherapy is a part of the standard preoperative systemic treatment options for breast cancer patients.This study intends to analyze the effect of neoadjuvant chemotherapy,the related clinical and pathological characteristics on the prognosis of breast cancer patients undergoing neoadjuvant chemotherapy in Sir Run Run Shaw Hospital.Materials and methods:A retrospective study was conducted on the clinicopathological characteristics of breast cancer patients who underwent neoadjuvant chemotherapy during January 2008 to January 2013 of the Sir Run Run Shaw Hospital.The relationship between these clinicopathological characteristics and the efficacy and prognosis of neoadjuvant chemotherapy was analyzed by statistical software.SPSS24.0 statistical software was used to perform univariate analysis of lymph node metastasis,efficacy,neoadjuvant chemotherapy,clinicopathological factors,and prognosis using the χ2 test.P<0.05 indicated statistical significance.Kaplan-Meier method was used for survival analysis.Cox regression analysis was used for multivariate analysis.P<0.05 indicated statistical significance.Results:A total of 175 female patients were recruited for pathological diagnosis of breast cancer and performed neoadjuvant chemotherapy at Sir Run Run Shaw Hospital.In terms of molecular classification,36 patients were Luminal A type,76 patients were Luminal B type(included 16 patients were Her-2 positive),31 patients were Her-2 overexpression and 32 patients were triple negativetype.There were no statistically significant differences in age,menopausal status,tumor size,regional lymph node metastasis and TNM stage among the groups.However,in the pCR rate,the triple negative type showed obvious advantages over the other three types(P<0.001).73 patients without regional lymph node metastases and 102 patients with regional lymph node metastases were evaluated before therapy.The 5-year OS without lymph node metastasis group was superior to that with lymph node metastasis group(94.5%vs 84.3%,p=0.036).There were 6 patients with stage cⅠ,131 patients with stage cⅡ,and 38 patients with stage cⅢ5-year DFS and OS in stage cl was better than in stage eⅡ and stage cⅡ was better than in stage cⅢ(DFS:85.7%vs.78.5%vs 55.3%,p=0.013;OS:100.0%vs.91.5%vs 76.3%,p=0.022).12 patients reached pCR after neoadjuvant chemotherapy,and 163 patients did not achieve the pCR.The 5-year DFS and OS that reached pCR group was significantly superior to the non-reached group(DFS:83.3%vs 73.6%;OS:91.7%vs 87.7%).In the multivariate analysis,it showed that the cTNM stage is an independent risk factor affecting affects prognosis.Conclusion:In neoadjuvant chemotherapy,the rate of pCR in patients with triple-negative breast cancer was higher than that of Her-2 overexpression group,which is superior to hormone receptor-positive group.In the neoadjuvant chemotherapy regimen,the objective response rate of anthracyclines and taxanes was better than that of anthracyclines or taxanes alone.T The size of the primary tumor before and after neoadjuvant chemotherapy and the status of lymph node metastasis were negatively correlated with the prognosis of breast cancer patients.cTNM stage is the independent risk factor for the prognosis of breast cancer patients. |
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