Clinical Pathology Characteristics And Prognosis Of Breast Cancer With Molecular Subtypes In The Elderly

Objective: To analyze the clinicopathological features and prognosis of breastcancer with different molecular subtypes in the elderly.Methods:The data of172elderly patients underwent surgery for invasive breastcancer in Liaoning Tumor Hospital from January2006to March2011were analyzedretrospectively.Based on immunohistochemistry, molecular subtypes were categorizedas follows:LuminalA[ER(+)or PR (+)and HER-2(-) and Ki67<14%]; LuminalB[ER(+)or PR (+) and HER-2(-)and Ki67≥14%],or [ER(+) or PR(+) and HER-2(+)]; HER-2(+)[ER(-) and PR(-) and HER-2(+)];triple negative [ER(-)and PR (-) and HER-2(-)].Theprognosis and differences of the various subtypes in age, histological type, tumor size,lymph node metastasis, clinical stage, histological grade and treatment wereanalyzed.157patients had complete follow-up data, the median follow-up time was52months and discuss the prognosis, The statistical analysis uses SPSS17.0, differences ofthe clinical and pathological features between the various subtypes use χ2test, survivalanalysis use the Kaplan-Meier, the difference in survival between groups uses Log-ranktest.Univariate analysis uses χ2test, multivariate analysis uses Cox model, a significantlevel of test, P <0.05.Results: Among the172cases, The mean age was70.1，The major pathologicaltype was invasive ductal carcinoma133(77.3%)，Specific types of cancer18(10.5%),LuminalA63(36.6%), LuminalB61(35.5%), HER-2(+)14(8.1%).triple negative34(19.8%). ER(+)117（68.0%），PR(+)103(59.9%)，HER-2(+)30（17.4%）。There weresignificantly differences in tumor size, clinical stage, histological grade, endocrinetherapy and chemotherapy among four molecular subtypes. There were no statisticallydifferences among different molecular subtypes regarding Age, lymph node status,histological type, surgical approach and radiotherapy (P>0.05). The proportion ofsmaller tumor, earlier clinical stage,better histological grade, receiving endocrine therapy was more in LuminalA than other subtypes,While the rate of receivingchemotherapy was lower (P <0.05).157had complete follow-up data, the medianfollow-up time was52months, The DFS of four molecular subtypes was91.2%,89.5%,76.9%,70.0%, OS was94.7%,93%,84.0%,80.0%. Univariate analysis showed thatmolecular subtypes, tumor size, lymph node status, clinical stage, histological gradewere the major prognostic factors.Multivariate showed that clinical stage,moleculartype,lymph node status and histological grade were independent prognostic factors.Conclusion:(1)There were statistically differences among different molecularsubtypes in tumor size, clinical stage, histological grade, endocrine therapy andchemotherapy.(2) The biological behavior of elderly patients is good, the elderlypatients have more Luminal subtype than others.(3)Luminal A subtype has the bestprognosis, triple negative subtype has the worst prognosis.(4) Clinical stage，molecularsubtype, lymph node status and histological grade were independent prognosticfactors for survival.