| BackgroundBreast cancer is a common malignancy in women.In recent years,due to the rapid development of medical science and technology and people’s awareness of medical treatment,breast cancer mortality has been reduced.But because of people’s lifestyle ideas and changes in the ecological environment,the incidence of breast cancer is also increasing significantly.The main Traditional markers of breast cancer to determine the biological behavior and prognosis are tumor volume,histological type,lymph node metastasis,TNM staging and so on.But breast cancer has obvious heterogeneity,there are significant differences in the treatment response and survival among the same histological type of breast cancer.Therefore,there is an urgent need to find biological markers,which are able to respond to of breast cancer heterogeneity in order to achieve the purpose of individualized treatment.With the progress of molecular genetics,the understanding of breast cancer gradually deepened,the detection of gene expression for better understanding of breast cancer heterogeneity and complex biological behavior is of great significance.Based on this,the concept of breast cancer molecular typing is proposed to reveal the biological characteristics of breast cancer from a deeper level.The molecular subtypes of breast cancer correspond reasonably well to a clinical characterization on the basis of hormone-and HER-2 status,as well as proliferation markers,which is used to guide the individualized treatment of breast cancer patients.In 2000,two professors at Stanford University presented the concept of molecular typing for the first time,Classification into five molecular subtypes,the classification based on immunohisto-chemistry(IHC)markers was recommended by the St.Gallen Expert Consensus in 2011 and confirmed again in 2013.Surrogate definitions of intrinstic subtypes of breast cancer classification from the St.Gallen Consensus 2013,LuminalA-like: ER,PR(+),HER-2(-),Ki-67 low(<14%),between luminalA-like and luminalB-like subtype,PR cut-point of ≥20% best corresponds to luminalA subtype;LuminalB-like:(1)(HER-2-negative): ER(+),Ki-67 over-expressed(≥14%)or PR(-)or low;(2)(HER-2-positive): ER(+),HER-2(+),any PR and any Ki-67;HER-2 positive-like(non-luminal): ER(-),PR(-),HER-2 Over-expressed or amplified;Triple negative: ER(-),PR(-),HER-2(-).For the definition of the previous two types,the 2011 meeting consensus is the same as the 2013 conference consensus.Tumor size,lymph node status,clinical stage,histologic type,histologic grade have been well established as prognostic and predictive factors for breast cancers.This study was designed to investigate the clinicopathological features of different subtypes of breast cancer and their relationship with patient survival.And to provide the theoretical basis for the individualized treatment of female breast cancer patients in Henan province.ObjectiveThrough the collection of clinical and pathological data of breast cancer,This study was designed to investigate the clinicopathological features of different subtypes of breast cancer and their relationship with patient survival.And to provide the theoretical basis for the individualized treatment of female breast cancer patients in Henan province.MethodsWe analyzed 538 cases with known Invasive breast cancer between January 2012 and December 2012 from The First Affiliated Hospital of Zhengzhou University.Using a retrospective analysis method,the various clinical and pathological datas were used to establish the database,including tumor size,histological grade,age,receiving of surgery and treatment methods.Results1.Among 538 case with know Invasive breast cancer,132(24.53%)were found to be LuminalA,211(39.22%)were LuminalB,83(15.43%)were HER-2 positive-like(non-luminal),112(20.82%)were triple negative.Luminal type of breast cancer accounted for the vast majority.2.No difference was found among four groups of patients with respect to age,menopausal state,race,family history,radiotherapy,receiving of surgery,lymph node status,AJCC stage and receiving of surgery oradiotherapy(P > 0.05).However,there are significant differences of tumor size,pathological type,histological grade,chemotherapy,endocrine therapy among four groups(P<0.05).3.The last follow-up date for this study was February 17,2017.538 cases of invasive breast cancer cases,40 cases died and 91 cases droped out during follow-up.The three-year overall survival rates(OS)of the four subtypes were 99.2%,96.2%,90.4% and 92.9%.Univariate analysis showed that tumor size,clinical stage,lymph node metastasis,surgical approach,endocrine therapy and molecular typing were the prognostic factors.Multivariate analysis showed that lymph node metastases to a certain number or extent(N3)and triple-negative subtypes were factors affecting the prognosis of breast cancer.ConcludesThe triple-subtype and lymph node metastasis to a certain number(N3)both were the prognostic factors of breast cancer. |
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