The Reanalysis Of Clinicopathologic Characterics And Prognosis Of Breast Conserving Therapy In TNBC

Bcakground and Objective: Triple negative breast cancer accounts for about 15% of the total breast cancer,which is manifested as the type with no expression of estrogen receptor,progesterone receptor and human epidermal growth factor receptor-2.Due to the lack of treatment means and corresponding targeted treatment,the current systemic treatment of this type of breast cancer is still dominated by chemotherapy.The most effective treatment is chemotherapy.For this type of breast cancer,the surgical method has become a major controversy.Some reports believe that the risk of distant metastasis of tri-negative breast cancer is high,but the risk of local recurrence is not high.Some reports believe that compared with other subtypes,tri-negative breast cancer does not increase the risk of local recurrence and distant metastasis.Other reports have suggested that triple-negative breast cancer does not increase the risk of local recurrence compared with other subtypes,but will shorten the overall survival period.Therefore,this study explored the possibility of triple negative breast cancer breast conserving treatment by analyzing the data of patients with breast conserving treatment in the breast center of tianjin medical university cancer hospital.In addition,basal like-type breast cancer accounts for the majority in the basal breast cancer among the tri-negative breast cancers,as this subtype presents a high malignancy in the tri-negative breast cancer,so this study will analyze this subtype alone to explore whether it is suitable for breast conserving treatment.Methods: 1.A total of 705 breast conserving patients admitted to tianjin medical university cancer hospital from 2007 to 2013 were selected to investigate the clinicopathological and prognostic data of all patients.2.Immunohistochemical staining(IHC)was performed on the tumor tissue samples of all patients,and the pathologists determined ER,PR,her-2 and other indicators to determine the basal-like type of breast cancer.3.Basal like-type breast cancer breast conserving data were analyzed to investigate prognostic risk factors in these patients.4.All clinical pathology and follow-up data were statistically analyzed by SPSS17.0(SPSS,Inc.,Chicago,IL,USA).Multivariate analysis adopted Cox proportional risk regression analysis method,and univariate variables with P < 0.01 were incorporated into multivariate Cox model for analysis.The difference between groups was determined by chi-square test.Kaplan-Meier method was used for univariate analysis and calculating LRFS,DMFS,DFS and OS,and the significance was assessed using the log-rank test.P < 0.05 was considered statistically significant.Results: 1.Age factor(35 years old)was statistically significant in each subtype(P=0.012),again proving that there were more young patients in TNBC.Histological grade was also statistically significant,with a higher proportion of grade III histology in TNBC.Adjuvant chemotherapy plays an important role in the comprehensive treatment of TNBC.2.Multivariate analysis showed that TNBC was very important for comprehensive treatment,and TNBC was not an independent prognostic factor associated with BCT.Therefore,BCT was one of the treatment options for TNBC.3.Basal-like breast cancer likewise has a lower onset age and higher histological grade.Adjuvant chemotherapy plays an important role in the comprehensive treatment.4.Multivariate analysis shows that,similar to TNBC asa whole,basal like-subgroup is not an independent prognostic factor in BCT,so BCT is one of the available treatment options for basal like-type TNBC.Conclusion: 1.TNBC is a subtype that accounts for a small proportion in breast cancer,but it is highly invasive,with a young onset age and high histological grade,and chemotherapy is still the main treatment method.This is true even with breast conserving therapy.2.TNBC is not an independent prognostic risk factor of BCT.Compared with other subtypes,TNBC does not show a higher risk of local recurrence,distant metastasis,overall recurrence and death.Therefore,BCT is an alternative treatment for TNBC patients.3.Basal-like breast cancer accounts for about 80% of TNBC around,is a high grade in TNBC,its characteristic and pathogenesis in patients with younger age,histologic grade III ratio is high,and is currently the only means of systemic therapy,chemotherapy for patients with early part of this subtype,as with TNBC,compared with other subtypes of breast cancer does not show the prognosis is poor,so,even if the basal-like breast cancer under the premise that accords with confirmed breast indications,still can choose insurance treatment.