Toxic--The Association Between Axillary-node-negative Breast Cancer And Molecular Subtypes And Probe The Prognostic Factors In This Class Of Breast Cancer

Objective:Probe the relationship between clinicopathological features and prognosis in axillary-node-negative breast cancer and molecular subtypes,summary its prognostic factors,which aimed to provide a basis for individualized treatment and assessing prognostic in this class of breast cancer.Methods:Classification of the axillary-node-negative breast cancer case into molecular subtypes was based on the expression of ER,PR,HER-2, Ki-67 by immunohistochemistry and fluorescence in situ hybridization. Collect clinical pathologically of axillary-node-negative breast cancer women patients confirmed by pathologically and its follow-up data which were followed up by outpatient and telephone interbiews.We analyzed the distribution of molecular subtyping in axillary-node-negative breast cancer. We analyzed the age,menopausal status,tumor size,TNM stage,histologic grade, And treatment of different molecular subtypes by statistical.Explore different molecular subtypes of prognostic and summary the prognostic factors of axillary-node-negative breast cancer(by Kaplan- Meier method and Cox proportional hazards regession).Results:All 420 cases,the proportion of Lumina-l A,Luminal B,HER-2 overexpression,basal like subtypes were20.95%(88/420),37.14%(156/420),12.62%(53/420),29.29%(123/420).We failed to find therelationship among age,menopausal status in molecular subtypes.In addition, basal like subtype with largest propotion(8.1%)in the less than 35 years old and with largest proportion premenopausal patients.We also failed to find the relationship between tumor size(P=0.105) and molecular subtypes,but HER-2 overexpression with a high T3 proportion(28.3%).TNM stage(P=0.026) and Histologic grade(P=0.007) were significantly different various subtyping,while HER-2 overexpression and basal-like subtype with a relatively late TNM stage and higher histologocal grade.HER-2 overexpression with a higher propotion of radiotherapy.410 cases were modified radical mastectomy.What′s more,there were 24 cases had radiotherapy and 362 in 420 cases had adjuvant chemtherapy.We did not find significant differences between surgical type(P=0.263) and chemotherapy(P=0.767)various subtyping,while sinificant difference in radiotherapy(P=0.001)and endocrine therapy(P=0.000). Kaplan-Meier analysis showed that the disease-free-survival was related to molecular subtypes(P= 0.021),while overal survival not(P=0.289).Age, menopausal status, molecular subtype and TNM stage were prognostic Indicators for disease-free survival, while age and TNM stage were independent predictor of overall survival by COXproportional hazards.Conclusion:In this study,we found that a certain correlation between axillary-node-negative breast cancer and molecular subtyping.TNM stage(P=0.026),,histological grade(P=0.007),radiotherapy(P=0.001) and endocrine therapy(P=0.000) were obviously different in molecular subtyping.No significantly statistical difference was found by age indiagnosis,menopausal status,tumor size,surgery approach and chemtherapy. Therefore,molecular subtype is an important prognositc indicator for axillary-node-negative breast cancer,while different subtyping with different DFS.COX proportional hazards model revealed that age,TNM installments,Molecular molecular subtypes and menopausal status were all independent prognostic factors for disease-free survival,while age and TNM installments were both independent prognostic factors for overall survival in axillary-node-negative breast cancer.