| BackgroundBreast cancer is one of the most common malignancy in women, and its incidence is increasing in recent years, more and more young women suffer ite Although the disease incidence of young breast cancer (age<35years old) is low, but it is generally believed that its biological behavior is strong aggressive, malignant and poor prognosis,which should be fully taken seriously.New breast of cancer patients in American is274,900in2006s, of which less than35years old accounted for2.7%, below the age of30accounted for0.6%, which is the leading cause of death in young women’s tumors. In recent years, the absolute number of young breast cancer patients in Europe and the United States rose slightly, but the disease incidence of breast cancer has not significant growth in young womenThe incidence of breast cancer in Asian populations is lower than it in the populations of Europe and North America, but the proportion of young breast cancer patients in Asian populations is significantly higher than that in the populations of Europe and North America. Reported in China, about5%-20%of patients with breast cancer is under the age of35, and2%-5%of patients with breast cancer is under the age of30. Because young patients of breast cancer have poor prognosis, its risk factors have increasing attention in recent years.Currently, the known risk factors:(1) family history:it is the most important young breast cancer risk factors. A Swedish study showed,in262cases of young breast cancer patients who is under40years of age, family history of breast or ovarian cancer patients accounted for48%. the radiation history:Be radiated can significantly increase risk of breast cancer of young women. Longo et al reported people who received chest radiotherapy for Hodgkin’s disease in patients with breast cancer before the age of55has the disease rate of29%, and3%in the normal population.(2) BRCA1/2mutations:BRCA1/2mutation in young breast cancer patients is more common. Studies have shown that breast cancer patients with BRCA1/2mutations were find cancer10years earlier than those without mutations.(3) Race:African ethnic women has lower incidence of breast cancer than it of Caucasians, but younger patient have a higher mortality rate. Similarly, the incidence of breast cancer in Asian populations is lower than the European and American crowd, but Asian populations has a significantly higher proportion of young breast cancer patients. In addition, other risk factors of breast cancer may also have an impact to young breast cancer, such as early age of menarche, smoking and obesity, which need to be further study.Breast cancer of young patients has strong aggressive, the main reason of it is the difference of the biological characteristics. Compared with the middle-aged breast cancer, young breast cancer has the following characteristics:Pathological type is mainly invasive cervical cancer, and about70%of invasive ductal carcinoma, high histological grade, Vascular invasion and axillary lymph node metastasis is more common, basal-like breast cancer and triple negative breast cancer is common. Therefore young patients have higher the proportion of the Clinical Ⅲ, Ⅳ and poorer prognosis compared with middle-aged patients. In recent years, the studies of the pathological features of young breast cancer reported the situation of hormone receptor gene expression and the various retrospective analysis of the results are not quite unanimous. Based on this, the study room of young breast cancer patients for undergraduate conducted a retrospective analysis of the clinical pathology We retrospectively analyzed the clinic-pathological data of breast cancer patients in NANFANG Hospital. ObjectiveBreast cancer is one of the most common malignant disease of women. Its incidence is increasing year by year and younger trend, the youth have the low incidence of breast cancer but the characteristics of breast cancer in young are Strong invasiveness, more malignance, the poor prognosis which Should be fully taken seriously. This study analyze the primary breast cancer clinical-pathological features and immunohistochemical data of106breast cancer patients who are under35years of age (including35-year-old).By it, we know the clinical Characteristics of young breast cancer patients in the region to provide guidance on the diagnosis and treatment.MethodsMaterials and Methods:The study retrospectively analyzed the clinic-pathological data of all breast cancer patients Who have complete clinic-pathological data in NANFANG Hospital from October2006to May2012. Two age categories were analyzed:young group (18<35years old, Average30.64years old, course of disease form5days to12months, Average course of disease2.8months, unmarried17cases, married89cases, n=106) and middle-aged group (36～78years old, Average45.04years old, course of disease form8,days to120months, Average course of disease10.4months, unmarried8cases, married632cases, n=640) as contrast group. All cases were confirmed by pathological examination。clinical features①young group:clinical manifestation are breast mass(94cases) and nipple discharge(12cases); tumor position distribution include the outer upper quadrant (62cases), the outer lower quadrant(12cases), the internal upper quadrant(18cases), the internal lower quadrant(14cases),left breast(42cases), right breast(64cases),②middle-aged group:clinical manifestation are breast mass(524cases), glandula mammaria calcify(78cases) and nipple discharge(38cases); tumor position distribution include the outer upper quadrant (421cases), the outer lower quadrant (96cases), the internal upper quadrant (88cases), the internal lower quadrant (35cases),left breast(362cases), right breast(298cases). The study confirmed Pathological type, Histological grade, lymph node metastasis by Routine pathological methods and detected the status of ER and PR, the expression of HER-2、Ki-67and P53by Immunohistochemistry。The tumor nuclei appeared brown particles like material positive positive critical value,1%of the nuclei of tumor cells positive ruled that any intensity coloring;Any tumor nuclei appeared brown particles is identified positive cell.≥1%of Tumor cell nuclei coloring judged as positive。 If there are ideal positive control,<1%of Tumor cell nuclei coloring judged as negative. Immunohistochemical detection of HER-2judging standard:negative, No coloring or cell membrane coloring;1+, Any proportion of cancer cells show weak or incomplete cell membrane coloring;2+,>10%of infiltrating cancer cells show weakly, moderately, full but uneven membrane of coloring, or<30%infiltrating cancer cells show strong and complete membrane of coloring;3+,>30%of infiltrating cancer cells show strong, complete and uniform membrane of coloring.3+determinate as HER-2positive; the case of2+must to detect of Fish to clear the situation of amplification. The immunohistochemical detection criterion of P53:P53expression is in the nucleus. Cases of less10%cancer cells with a positive nuclear staining were defined as negative (-), on the contrary, other cases were defined as positive(+).The immunohistochemical detection criterion of Ki-67:The cells stained cell nucleus brownish yellow are positive cells. For different sample, if there are less10%positive cells in a sample,which would be considered negative (-); the samples with11%-25%positive cells were considered weakly positive (+); the samples with26%-50%positive cells were as positive (++); and the samples with more than50%positive cells were defined as strongly positive(+++).No amplification is determined negative, the amplified judge as positive. Data analyze by SPSS13.0Statistical Package for the chi-square test, P<0.05is considered statistically significant.Results:78cases is infiltrating ductal carcinoma in Youth group accounting for73.58%of the total;12cases is intraductal carcinoma, accounting for11.32%;16cases is other types (including invasive lobular carcinoma and mucinous carcinoma etc.) accounting for15.10%.497cases is infiltrating ductal carcinoma in middle-aged group,accounting for77.66%of the total;65cases is intraductal carcinoma, accounting for10.16%;78cases is other types, accounting for12.19%.Compared with the middle-aged group, the difference of various pathological type in the youth group is not statistically significant (P>0.05). Histological grade in the youth group is grade Ⅰ:24cases, grade Ⅱ:69cases, grade Ⅲ:13cases; histological grade in the middle-aged group is grade Ⅰ:115cases, grade Ⅱ:454cases, grade Ⅲ:71cases; compared with the middle-aged group, the difference of various histological grade in the youth group was not statistically significant (P>0.05).The positive expression of ER, PR, Her-2and Ki-67is61,55,79and77cases in he youth group, accounting for57.55%,51.89%,74.53%and72.64%respectively;493,473,333, and364cases in the middle-aged group respectively, accounting for77.03%,73.91%,52.03%and56.88%respectively.Compared with the middle-aged group, the difference of the positive expression of ER, PR, Her-2and Ki-67in the youth group was statistically significant (P<0.05)The positive expression of P53is44cases in the youth group, accounting for41.51%;281cases in the middle-aged group, accounting for43.91%. The positive expression of P53is not statistically significant (P>0.05) between the.youth group and the middle-aged group, lymph node metastasis is72cases, accounting for67.92%;285cases in the middle-aged group, accounting for44.53%. the difference of lymph node metastasis was statistically significant (P<0.05) between Youth group and middle-aged group.Conclusion:This study shows that there was no significant difference in pathological types, histological grade between young group and middle-aged group. However, there is significant difference in the expression of ER, PR, HER-2,Ki-67and the rate of lymph node metastasis. This study shows that there is no relevant between age and the pathological types and the histological grade. But the expression of ER, PR, and the rate of lymph node metastasis have more relationship with age. Breast cancer in young patients is aggressive and easy to migrate, besides the pathological types, the poor prognosis has relationship with the time of treatment and the compliance of patients. Some studys show that early treatment can improve notablely the prognosis of breast cancer in young patients. So it can improve notablely the prognosis of breast cancer and enhance breast cancer patients’survival rate that inspecting by oneself, medical examination regularly, early discovery and early treatment, Coordinating treatment actively after final diagnosis, receiving normalization treatment, furthermore young women don’t think the breast cancer only for middle-aged women. |
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