Pathological Types,clinical Characteristics And Prognosis Of Young Breast Cancer

Objective By dividing young breast cancer patients under 45 years old into 3 groups,comparing the pathological types and clinical characteristics of different age groups,and analyzing the correlation and difference of prognosis,to evaluate the age limit of young breast cancer patients and which factors are the risk factors of young breast cancer,so as to provide reference for individualized treatment of young breast cancer in the future,reduce the recurrence and metastasis probability,and improve the survival rate and quality of life of young breast cancer patients.Methods: A retrospective study was conducted to collect the complete clinical data and follow-up information of young breast cancer patients from January 1,2006 to January 1,2019 in the Affiliated Hospital of Inner Mongolia Medical University.A total of 205 cases met the inclusion and exclusion criteria,10 cases were missed,and 195 cases were finally included in the grouping.According to the age of onset,they are divided into 3 groups: under 35 years old,35-40 years old,and 40-45 years old.Among them,23 cases are divided into groups under 35 years old,60 cases are divided into groups 35-40 years old,and 112 cases are divided into groups 40-45 years old.The data collected include: 1.General factors: onset age,menarche age,breast feeding history,birth history,family history of malignant tumor,etc.2.Clinical factors: primary tumor size,number of lymph node metastases,relevant blood biochemistry before chemotherapy starts,tumor marker level,and auxiliary examination results(judging whether metastasis exists or not).3.Pathology and molecular biological factors: tumor pathological classification,clinical stage(TNM stage),histological grade,estrogen receptor(ER),progesterone receptor(PR),expression of human epidermal growth factor receptor-2(HER-2)and Ki-67,etc.4.Treatment factors: chemotherapy,standard radiotherapy,standard endocrine therapy,targeted therapy for HER-2 overexpression patients,etc.5.Prognostic factors: disease-free survival time,total survival time,recurrence or metastasis,recurrence and metastasis interval.SPSS17.0 software was used to carry out statistical correlation factor analysis,and disease-free survival time(DFS)and overall survival time(OS)for 3 and 5 years of patient-related factors were calculated,and survival curves were drawn for survival analysis.Results 1.Clinical and Pathological factors:(1)there was no difference in the primary tumor size,lymph node metastasis,clinical stage,pathological type,pathological typing,ER,PR and Ki-67 expression of three different age groups of young breast cancer patients,but there was difference in the reproductive history and HER-2 expression(P<0.05).(2)The proportion of young breast cancer patients younger than or equal to 35 years old who have no reproductive history is significantly higher(17.4% vs 3.3%,1.8%,P=0.009),and the proportion of HER-2 overexpression in young breast cancer patients younger than or equal to 35 years old is higher(65.2% vs 41.7%,32.1%,P=0.011).2.Treatment factors: There is no significant difference in the choice of major surgical methods,chemotherapy,endocrine therapy,radiotherapy and targeted therapy among the three different age groups.3.Prognostic factors:(1)disease-free survival time(DFS)and overall survival time(OS)in 3 and 5 years are significantly correlated with primary tumor size,lymph node metastasis,clinical stage,ER,HER-2 and Ki67 expression,with statistically significant difference(P<0.05),but not with other statistical factors.(2)Multivariate analysis showed that ER negative(P=0.029,RR=2.112),N1/2/3(P=0.005/0.017/0.011,RR=3.231/3.580/4.554)passed the significance test at 5%,which was an independent risk factor affecting OS.ER negative(P=0.000,RR=3.149),N1/2/3(P=0.008/0.042/0.011,RR=2.639/2.595/3.456),HER-2 positive(P=0.035,RR=1.900)passed the significance test at 5%,which is an independent risk factor affecting DFS.Conclusions 1.ER negative,Positive lymph node metastasis and HER-2 positive are independent prognostic risk factors for young breast cancer patients.2.The first-line standardized treatment for breast cancer is suitable for young breast cancer patients,with no obvious difference.3.The proportion of HER-2 overexpression in young breast cancer patients under 35 years old is high.4.Compared with the other two groups,the disease-free survival time(DFS)and overall survival time(OS)of young breast cancer patients under 35 years old are significantly different,and have the characteristics of short disease-free survival time,high recurrence risk and high mortality rate.