Research On The Correction Between Prognostic Factors Of Primary Breast Cancer And Disease-Free Survival

[Background and Purposes]Breast cancer is one of the most common female malignant tumors in China and is now becoming the first fatal female tumor. The incidence of breast cancer in China increases year by year; the annual number of new cases reaches 169,000 with annual growth rate of 4.476%. and it shows a younger trend. Breast cancer, therefore, becomes the number one threat to women’s health. And breast cancer is a kind of malignant tumor that is regulated by the hormone receptor and is highly heterogeneous, and shows different molecular subtypes, and tumor characteristics, as well as other indicators; all these affect the disease-free survival (DFS), recurrence metastatic rate and prognosis of patients. Through analyzing the complete follow-up information records of patients with breast cancer treated in Hunan Provincial People’s Hospital and Hunan Tumor Hospital in recent years, the research explores and forecasts the related factors affecting the prognosis of patients with breast cancer, and provides the reference for the prognosis assessment and treatment of patients with breast cancer.[Data and Methods]Through retrospective investigation, the complete follow-up clinical data and general information of 108 cases of patients with breast cancer treated in Hunan Provincial People’s Hospital and Hunan Tumor Hospital from January 2007 to December 2010 are collected, including general conditions, menopausal status, tumor size, presence of calcification of tumor, molecular classification, histologic staging, clinical staging, estrogen receptor (ER) and progesterone receptor (PR) as well as Her-2 state, VDR state, adjuvant therapy, metastatic time and place. The relationship of various factors and the DFS of patients is analyzed; statistic analysis and survival analysis are conducted withSPSS19.0for windows software package; Kaplan Meier method is used and survival curve is drawn; single factor analysis is carried out by using Log-rank logarithmic test; the factors influencing the DFS of patients are found; finally, multiple-factor analysis is conducted by applying Cox risk regression model analysis.[Results]1. According to single factor analysis, age, primary tumor size, lymph node metastasis, clinical stage, the absence or presence of tumor calcification, VDR expression in tumor and adjuvant chemotherapy have an effect on patients with DFS (P<0.05). According to multiple factors analysis, age, lymph node metastasis, adjuvant chemotherapy, the absence or presence of tumor calcification and VDR expression in tumor are the independent influencing factors for the patients with DFS (P<0.05). The effect of molecular classification, menstrual status, pathological classification, ER, PR, Hers-2 state on patients with DFS has no obvious statistical significance.2. As for patients with primary breast cancer tumor, calcification, positive expression of VDR, and the recurrence and metastasis of postoperative chemotherapy emerge relatively later; the patients who receive anthracene ring and yew class combination chemotherapy regimens have better living conditions of neutral positions. Patients with small onset age and large number of lymph node metastasis have distant metastasis earlier.3. The parts where primary breast cancer metastasis most frequently emerges are bone, lung and axillary lymph nodes in turn. Among all of the patients with bone metastases, the ones with lumbar spinal metastases occupy the most (42.8%). And the patients with visceral metastasis have better prognosis, with median DFS being 30 months. By contrast, patients with visceral metastasis have poorer prognosis, with the median DFS being 20 months. Patients with brain metastases have the worst prognosis.[Conclusions]1.Primary breast tumor calcification and positive expression of VDR may cause less recurrence and metastasis, and have better prognosis; postoperative chemotherapy may improve the prognosis of patients.2.Young primary breast cancer or the ones with axillary lymph node metastasis is more likely to appear recurrence and metastasis.