Correlation Study Between Mammographic Tumor Edge Features And Prognostic Factors Of Breast Cancer

Objective: To investigate the correlation between the mammographic tumor margin features and prognostic factors(ER、PR、Her-2、p53、Ki-67 and lymph node metastasis.)of breast cancer.Methods: 243 cases of breast cancer were included in this study.Mammography were performed in all patients, and all patients were operated and proved by pathologic examination.The expression level of estrogen receptor(ER), progesterone receptor(PR) and human epidermal growth factor receptor-2(HER-2)、P53、Ki-67 were gauged by immunohisto chemistry.The mammographic tumor margin features of all cases were analyzed. The correlation between the mammographic tumor margin features and the expression level of ER、PR、HER-2、P53、Ki-67 and lymph node metastasis were analyzed. Application of SPSS13. 0 for chi square test and correlation analysis of P<0.01 was considered statistically difference.Results:1 The pathological results: in 243 patients with simple mass, 186 cases ofinfiltrating ductal carcinoma, 16 cases of medullary carcinoma,11 caces of Infiltrating duct- lobular mixed tumor,9 cases of invasive lobular carcinoma, 1 cases of apocrine carcinoma,3 cases of non invasive carcinoma, 7 cases of mucinous carcinoma,1 case of tubular carcinoma,3 cases of papillary carcinoma,1 case of Adenosquamous carcinoma, 2 case of large cell neuroendocrine carcinoma,2 cases of metaplastic carcinoma,1 case of sarcomatoid carcinoma.2 According to the tumor edge features are divided into:(1) 33 cases withclear margin,89 cases of partial clear,121 cases of edge blurry;(2) 159 cases of edge lobulation, 84 cases of no lobulation;(3) 135 cases of edge of burr sign,108 cases of no burr syndrome;(4) 166 cases of edge halo ring sign,77 cases of no halo sign.3 The relationship between the mammographic tumor edge features and the expressions of ER, PR, Her-2, P53 and Ki-67 and lymph node metastasis.(Table1-6)In 243 cases of breast cancer patients,the expression of ER in 172 cases,positive accounted for 70%,the expression of PR in 149 cases, positive accounted for 61%,the expression of Her-2 in 61 cases, positive accounted for 25%, the expression of P53 in 125 cases, positive accounted for 51%, the expression of Ki-67 in 199 cases, positive accounted for 82%,lymphatic metastasis in 98 cases were positive,accounted for 40%.(1)The edge whether clear had no correlation with the expressions of ER, PR, Her-2, P53,Ki-67 and lymph node metastasis.(2) The positive expression of PR is different between the lobulated edge and no lobulation edge,The lobulation group had high PR expression, no lobulation group was lower,there was statistical significance in the difference between the two groups(P=0.005). The positive expression of Her-2 is different between the lobulated edge and no lobulation edge,The lobulation group had low Her-2 expression, no lobulation group was higher,there was statistical significance in the difference between the two groups(P=0.014). The edge whether had lobulated edge had no correlation with the expressions of ER, PR, Her-2, P53,Ki-67 and lymph node metastasis.(3) The positive expression of ER and PR is different between the burr syndrome edge and no burr syndrome edge,the burr syndrome group had highER and PR expression, no burr syndrome group had lower,there was statistical significance in the difference between the two groups(P=0.000). The Her-2 positive expression is different between the burr syndrome edge and no burr syndrome edge,the burr syndrome group had low Her-2 expression, no burr syndrome group had higher,there was statistical significance in the difference between the two groups(P=0.003). Edge burr syndrome and no burr syndrome positive lymph node metastasis rate of different,glabrous thorn syndrome group was higher, burr syndrome group was lower, there was statistical significance in the difference between the two groups(P=0.026). Edge burr syndrome had no correlation with the expression of P53 and Ki-67.(4) Edge halo syndrome had no correlation with the expressions of ER, PR, Her-2,P53, Ki-67 and lymph node metastasis.Conclusion:There is a correlation between the tumor lobulated edge and positive expression of PR and Her-2.Lobulation edge of breast cancer had higher PR expression and lower Her-2 expression.It suggested that these patients had the lowerdegree of malignancy and better prognosis. Burr edge syndrome had a certain correlation between the expressions of ER, PR, Her-2 and lymph node metastasis.Tumor edge burr sign of breast cancer had a higher ER, PR expression, lower Her-2 expression and lower lymph node metastasis.It illustrated that thesepatients had lower malignant degree, the prognosis is good, low recurrence risk.The mammographic features of the breast cancer had some correlation with the expression of ER,PR,Her-2,P53,Ki-67 and lymphatic metastasis.It is a feasible to predict the expression of ER,PR,Her-2,P53,Ki-67 in breast cancer. So the biological behavior can be assessed by mammographic features which provide information for prognosis and therapy.