Analysis Of Diagnosis And Treatment Of Breast Cancer In Young Women

Objective To explore the clinicopathological characteristics,prognostic factors and clinical diagnosis and treatment of young breast cancer.Method To retrospectively analyze the clinicopathological and prognostic data of breast cancer patients who were diagnosed in the First Affiliated Hospital of Guangxi Medical University between January 2013 to April 2015 through pathological diagnosis in the hospital.The patient relapses and metastases,as well as deaths,were followed at the outpatient or telephone visits every 3 months after discharge.They were divided into the former group(young group,<40 years old),the middle group(40 to 49 years old)and the latter group(≥50 years old).The statistical data were analyzed by SPSS20.0 system.Chi-square test or Fisher’s exact test was used to compare the clinicopathologic features of the young group and the other two groups.Kaplan-Meier curves and Log-rank test were used to establish the recurrence metastasis and survival of breast cancer patients after surgery.COX proportional hazards regression model was used for univariate and multivariate analysis to estimate hazard ratio(HR)and 95% confidence interval(CI)to analyze prognostic factors of breast cancer in young women(BCYW).Result This study included 669 women with stage I-III invasive breastcancer,134(20.0%)in the young women breast cancer group,249(37.2%)in the middle group,and 286(42.8%)in the latter group.BCYW had significant differences in disease course,tumor size,axillary lymph node metastasis,TNM staging,ER,PR,molecular typing and histological grade distribution,breast surgery,and postoperative adjuvant therapy compared with other two groups(P<0.05),but there was no significant difference in HER-2 receptor expression,Ki-67 index,neurovascular invasion,and adjuvant endocrine therapy(P>0.05).Univariate analysis of prognoses in BCYW revealed that the adverse factors of postoperative recurrence in young breast cancer patients include the disease duration was greater than 12 months(HR: 2.737),axillary lymph node invasion(HR:2.683)and tumor stage(HR:2.347).Family history of breast cancer(HR:9.770)and course of disease more than 6 months(HR:11.084)were risk factors for overall survival within 5 years after BCYW surgery(all P<0.05).Multivariate analysis showed that family history of breast cancer and higher TNM staging were independent prognostic factors for overall survival within 5 years after surgery.BCYW had a higher postoperative recurrence and metastasis rate than older patients(P<0.05).When analyzed by biotyping,there was no significant difference in DFS and OS between the BCYW and the latter two groups within 5 years after operation on Luminal A,HER-2,and TNBC type breast cancers(P>0.05).However,in Luminal B-type breast cancer,the prognosis of young patients was poor(P < 0.05).Conclusion Younger breast cancer patients have longer disease course,higher TNM staging,and poorer prognosis than older patients.Family history and TNM staging are independent prognostic factors affecting OS in young patients within 5 years after surgery.Young patients with breast-conserving therapy had better DFS than patients undergoing radical resection within 5 years,but there was no significant difference in OS within 5 years.For Luminal B type breast cancer,BCYW have a worse prognosis than older patients.