Analysis The Correlation Between Endocrine And Targeted Therapy And Prognosis In 179 Patients With Stage Ⅱ And Ⅲ Breast Cancer

Objective:To investigate the efficacy of endocrine and targeted therapy in the treatment of 179 patients with stage Ⅱ and Ⅲ breast cancer according to different hormone receptors and HER-2 gene status,whether endocrine therapy and Hessetin targeted therapy And to explore the correlation between endocrine and targeted therapy of triple positive breast cancer,and to provide theoretical basis for the individualized treatment of patients with stage Ⅱ and Ⅲ breast cancer.Methods:A total of 179 patients with stage Ⅱ and Ⅲ breast cancer were enrolled in the First Affiliated Hospital of Dalian Medical University from January 2004 to January 2014 through the electronic medical record system.All women were excluded from the three-negative breast cancer patients.Neoadjuvant chemotherapy,postoperative adjuvant chemotherapy ≥ 4 cycles,patients with radiotherapy indications were received postoperative adjuvant radiotherapy.From the operation time to follow the recurrence of recurrence.By analyzing the correlation between clinicopathological features and DFS,the prognostic features were studied.At the same time,all patients were divided into 4 groups,group 1:HER2 overexpression and hormone receptor negative group,patients were treated with Herceptin targeted therapy;group 2:HER2 negative and hormone receptor positive group,patients were endocrine therapy;Group 3:triple positive breast cancer endocrine therapy group;group 4:triple positive breast cancer endocrine combined with targeted therapy group.The effect of endocrine therapy on DFS was investigated by comparing DFS in group 2 and group 3 patients with different HER-2 status.By comparing group 1 and group 4 patients with DFS,the effects of different hormone receptor status on the treatment of DFS with breast cancer Herceptin were studied.By comparing the DFS of group 3 and group 4 patients,the effects of endocrine therapy combined with targeted therapy on DFS were analyzed in patients with triple positive breast cancer.Result:1.Relationship between clinicopathological features and DFS in patients with stage Ⅱand Ⅲ breast cancer179 cases of postoperative stage Ⅱ,Ⅲ breast cancer patients,the youngest 28 years old,the largest 72 years old,the average age of 52.65 ± 9.8 years old to 35 years old and 60 years old,<35 years old in 23 cases,≥35 years And<60 years old 114 cases,≥ 60 years old in 42 cases.The average mass of the tumor size of 3.12 ± 1.19,2cm and 5cm as the boundary,≤ 2cm in 25 cases,>2cm and ≤ 5cm in 130 cases,>5cm in 24 cases,postoperative pathological stage of stage Ⅱ breast cancer in 118 patients,61 cases.107 patients with pathology suggest lymph node metastasis,72 patients without lymph node metastasis.90 cases of postmenopausal patients were diagnosed,89 cases were not menopause.There were 146 patients with invasive ductal carcinoma,33 patients with invasive lobular carcinoma and other patients.Pathologic grade Ⅱ patients in 113 cases,grade Ⅲ patients in 57 cases,pathological grade 9 cases.Radical surgery or modified radical mastectomy in 138 patients,breast resection and breast conserving surgery in 41 patients.DFS was correlated with postoperative pathological stage,pathological grade and lymph node metastasis,P<0.05.Suggesting that postoperative pathological staging,pathological grade and lymph node with or without metastasis of breast cancer prognosis adverse factors.2.Effects of endocrine therapy on DFS in different HER-2 statesGroup 2 patients in 45 cases,accounting for 25.1%,DFS minimum 4.5 months,the longest 170.23 months,the median DFS was 62.13 months.Group 3 patients were 57 cases,accounting for 31.8%,DFS shortest 7.23 months,the longest 106.87 months,the median DFS was 44 months.The results showed that patients with HER-2 over expression had a median DFS of less than HER-2-negative patients in patients with breast cancer who were hormone-positive and endocrine therapy,with a Mann-Whitney U test,p<0.05.Suggesting that HER-2 gene over expression in patients with endocrine therapy benefits decline.3.Effects of trastuzumab on DFS in different hormone receptor status of breast cancerGroup 1 patients were 35 patients,accounting for 19.6%,DFS shortest 4.23 months,the longest 110.50 months,of which DFS was 59.97 months.Group 4 patients in 42 cases,accounting for 23.5%,DFS shortest 15 months,the longest 121.50 months,the median DFS was 53.25 months.The results showed that in the patients with breast cancer treated with HER-2 over expressing and treated with trastuzumab,the median DFS was less than the ER-negative group in the ER-positive group and p<0.05 by the Mann-Whitney U test.Statistical significance.Suggesting that ER-positive breast cancer patients,targeted treatment benefit decreased.4.The effect of endocrine therapy on DFS in patients with triple positive breast cancerAmong the 179 patients,there were 99 cases(30.3%)of the patients with triple positive breast cancer,accounting for 55.3%of the patients who were treated with endocrine therapy.The patients were divided into three groups:31.8%,the shortest DFS was 7.23 months and the longest was 106.87 months,Where the bit DFS was 44 months.Endocrine combined with targeted therapy in 42 patients,divided into group 4,accounting for 23.5%,DFS shortest 15 months,up to 121.50 months,the median DFS was 53.25 months.The results showed that in patients with triple positive breast cancer,endocrine combined with targeted therapy group of patients with DFS higher than single endocrine therapy group,Mann-Whitney U test,p<0.05,the difference between groups was statistically significant.Suggesting that triple positive breast cancer clinical endocrine combined with targeted therapy benefit more.Conclusion1.In the HER-2 positive and targeted breast cancer patients,the ER-positive group was less likely to benefit from the treatment of ER-negative patients than in the ER-negative group.2.In the ER-positive and endocrine-treated breast cancer patients,the HER-2 gene expression group decreased the benefit of endocrine therapy in patients with low expression of HER-2 gene.3.To triple-positive breast cancer patients,endocrine combined with targeted therapy than endocrine therapy benefit more.