Comparison Of Clinicopathological Characteristics And Prognosis Of Triple-positive Breast Cancer And HER2-Overexpressed Breast Cancer

Objective:To analyze the clinicopathological characteristics,prognosis and associated risk factors of triple-positive breast cancer and HER2 overexpressed breast cancer.Methods:Clinical data of a total of 201 patients with HER2-positive breast cancer admitted to the Department of Breast and Thyroid Surgery of Shandong Provincial Hospital from January 2013 to December 2015 were collected.The cases were divided into 103 cases of triple-positive breast cancer(HR-positive/HER2-positive)and 98 cases of HER2 overexpressed breast cancer(HR-negative/HER2-positive)according to the different hormone receptor status.The clinicopathological characteristics,treatment and prognosis of the two groups of patients were compared.All statistical data were analyzed in detail using SPSS25.0 statistical software,and P<0.05 indicated that the differences were statistically significant.Results:1.There were 201 patients in total in this study,including 103 patients(51.2%)with triplepositive breast cancer and 98 patients(48.8%)with HER2 overexpression breast cancer.2.Clinicopathological characteristics:there were no statistical differences between the triple-positive and HER2 overexpression groups in age,menstrual status,tumor size,number of lymph node metastases and TNM stage.(P>0.05).There was a statistical difference in the distribution of Ki-67 protein levels between patients in the triple positive and HER2 overexpression groups(p=0.003).3.Treatment:All 201 breast cancer patients underwent modified radical mastectomy,and there was no significant difference in the choice of postoperative radiotherapy and chemotherapy regimens between the two groups(P>0.05).Ninety-nine patients(96.1%)in the triple-positive group completed 5 years of endocrine therapy.There was a statistically significant difference in the composition ratio of patients in the two groups who underwent targeted therapy postoperatively(P=0.025).4.Prognosis:The 5-year disease-free survival rates of patients in the triple-positive group and the HER2 overexpression group were 85.4%and 65.3%,respectively,and the 5-year overall survival rates of patients with breast cancer in the two groups were 95.1%and 81.6%.5.Subgroup analysis:There was a statistically significant difference in recurrent metastasis between the triple positive group of breast cancer patients and the HER2 overexpression group suffering from different chemotherapy regimens(P=0.020,P=0.003).DFS was statistically significantly better in both groups with trastuzumab than in the non-use group(P=0.009,P=0.015).Overall OS was higher in the triple-positive group,and death was statistically different between AC-T and other chemotherapy regimens(P=0.012).OS was significantly higher in the subgroup with targeted drugs than in the subgroup without targeted drugs in both groups.6.Results of univariate analysis:5-year DFS univariate COX proportional risk regression with results for age,menopausal status,TNM stage,hormonal receptor status,whether targeted therapy was given after surgery,whether radiotherapy was given after surgery were influential factors for the development of recurrent metastases in HER2-positive breast cancer patients.5year OS univariate COX proportional risk regression,showed that hormonal receptor status,whether targeted therapy was given postoperatively,and whether radiotherapy was administered after surgery were influential factors in the presence of death in HER2-positive breast cancer patients.7.Results of multifactorial analysis:5-year DFS multifactorial COX proportional risk regression,showed that hormonal receptor status,Ki67 status and the presence of targeted therapy after surgery were independent risk factors for the development of recurrent metastasis in HER2-positive breast cancer patients.A 5-year OS multifactorial COX proportional risk regression showed that the maximum tumor diameter,hormonal receptor status and the presence or absence of postoperative targeted therapy were independent risk factors for death in patients with HER2-positive breast cancer.Conclusions:1.There were no statistical differences in age,menstrual status,tumor size,number of lymph node metastases and TNM stage between patients in the triple positive group and those in the HER2 overexpression group,while there were significant differences in Ki67 protein expression levels.2.The overall prognosis of patients in the triple-positive group was significantly better than that of the HER2 overexpression group.3.The prognosis of the targeted group was significantly better than the untargeted group in both groups of breast cancer patients;there was also a significant difference in prognosis between the two groups after the use of the same chemotherapy regimen.4.Tumor size,distribution of Ki-67 protein levels,hormonal status and whether to target therapy after surgery are independent risk factors for survival prognosis of HER2-positive breast cancer patients.5.We should fully assess the risk of recurrence in breast cancer patients,such as hormone receptor status,HER2 expression,tumor diameter size and lymph node metastasis,and then choose the appropriate treatment plan to give the patient the maximum benefit.