Analysis Of Diagnosis And Treatment Of Breast Cancer Treated With Neoadjuvant Chemotherapy (With 72 Cases Reports)

Objective To explore the curative effect and prognostic value of neoadjuvant chemotherapy (NAC) in breast cancer treatment.Methods Rerrospectively analyze breast cancer treated with neoadjuvant chemotherapy(NAC) and surgery from May 2012 to October 2015 in our hospital.Breast cancer was determined the molecular subtype (MST) according to the histopathological and immunohistochemical diagnosis report when firstly diagnosed.Tumor size change after NAC and tissue pathology reactivity after excision ect.were used for evaluating the curative effect of NAC.Research the follow-up of postoperative recurrence and metastasis combined with breast cancer surgery, postoperative adjuvant therapy data.SPSS21.0 statistical software was adopted to analyze the difference of clinical pathological data,pathologic complete response circumstance after NAC and operation method.Kaplan-Meier method was applied to analyze he difference of postoperative disease-free surial.Result 72 women patients with clinical Ⅱ,Ⅲ,stage breast cancer accepting NAC were diagnosed to Luminal subtype(45 cases), HER2+ subtype(13 cases) and TN subtype(14 cases) by the immunohistochemical diagnosis report.There was no statistical significance in age, menstrual status,clinical stage before NAC, operation method of breast and axilla, the number of axillary lymph nodes among three MSTs of breast cancer.All 5 cases invasive lobular carcinoma were belong to Luminal subtype.Histological grade level 3 cases were associated with MST (p=0.047), TN subtype with 50% (7/14),then HER2+ subtype with 30.8%(4/13).The difference of pathological T stage among different MST was statistically significant (p=0.041), ypT0～T2 breast cancer can be found in most of HER2+subtype (84.6%) and TN subtype(71.4%),nevertheless,ypT3 was most found in Luminal subtype (55.6%).Similarly,the difference of ypN among different MST was statistically significant (p=0.009).TNBC more easily approach to pN0 after NAC (57.1%), on the contrary, Luminal subtype has more ypN2(44.4%).The differences of overall pathological stage after NAC was statistical significance (p=0.024), pathological stage Ⅲ was performed most in Luminal subtype(55.6%), however,HER2+ subtype(76.9%) and TNBC (85.7%) were given priority to with 0～Ⅱ stage.:Luminal subtype has highest proportion of the number of positive axillary lymph nodes of four or more (50%,p=0.013).HER2+ subtype, and TNBC likely achieved pCR after NAC (p=0.045).The total effective rate(CR+PR) was 62.5% compared the length-diameter of ultrasonic detection of breast cancer before to after NAC,the highest effective rate was HER2+ subtype(84.6%,p=0.027).A median follow-up of 20 months (range 7-39 months) showed that the difference of disease-free survival and MST of breast cancer was no statistically significant (p=0.130).Whereas, the disease-free survival curve presented prominent trend that TNBC had lower disease-free survival rate than Luminal and HER2+ subtype breast cancer.Conclusion HER2+ and TN subtype breast cancer had better response to neoadjuvant chemotherapy.TN subtype breast cancer performed higher histologic grade, higher malignant degree,and prominent trend lower disease-free survival rate.