| Objective: To summarize clinicopathological characteristics and different therapies of triple negative breast cancer(TNBC)patients who were 65 years and older.Analyze the factors affecting treatments and prognosis.provide theoretical basis for personal treatments scheme fit for Chinese elderly women with triple negative breast cancer patients.Methods: The clinical characteristics(such as age,pathological pattern,tumor size,TNM staging,lymph node metastasian P53 and so on)of 946(146 cases were triple negative breast cancer)elderly women with breast cancer who were definited primary cancer and treated with surgery in Tianjin Medical University Cancer Institude and Hospital from January 2005 to December 2009 were analyzed retrospectively.In whom 868 patierns were followed-up completely and screened out 132 patients with triple negative breast cancer according to inclusion and exclusion.We summarized the clinicopathological characteristics of elderly women with triple negative breast cancer patients Compared with elderly women with non-triple negative breast cancer patients.To compare and analyze the differences in the treatment patterns and findout the affecting factors.Chi-square test was conducted to test the influencing factor in different survival state,when KaplanMeier was used to do univariate analysis of predictors for disease free survival(DFS)and overall survival(OS)of elderly patients.with BC and Cox was used to do the multivariate analysi.Results: Of the 132 patients,the median survival age is 71 years old,and age ranged from 65 years to 90 years.54 cases were 65-70 years old,46 cases were 61-75 years old and 32 cases were over 75 years old.With a higher proportion of other comorbidities(91/132 68.9%),of which 58 cases of hypertension,40 cases of coronary heart disease,16 cases of diabetes,6 cases of cerebral vascular disease,2or more complications about 34.8%(34/132).30 cases died in 5 years after surgery when 6 cases died from other complications.31 cases relapsed or metastasized.Invasive ductal carcinoma is the main pathological type.Most of the histological grade was two.The tumor size was mainly 2-5cm.The lymph node metastasis rate was high,and the TNM stage was mainly in the second stage.There were 103 cases underwent Radical operation and 82 cases underwent chemotherapy.Neoadjuvant chemotherapy in 10 cases and radiotherapy in 18 cases.Compared with elderly women who were non-triple negative breast cancer patients,the breast cancer of elderly women with triple negative type had higher histological grade(gradeⅠwaslowerand grade Ⅲ wan higher),higher p53 positive ratio,higher proportion of chemotherapy,and lack of endocrine therapy.Univariate analysis showed that operation method was correlated with age and pathological pattern and Chemotherapy in elderly triple negative breast cancer patients was correlated with the age of menarche,family history of malignant tumor,tumor size and lymph node metastasis,when radiotherapy was correlated with TNM staging and lymph node metastasis.Multivariate analysis showed that pathological type is an independent factor in the operation method and tumor size and lymph node metastasis are independent factors in Chemotherapy and lymph node metastasis is an independent factor in radiotherapy.5-year recurrence and metastasis-free survival rate and overall survival rate in these patients were 77.0%(97/126)和 81.0%(102/126),which were all correlated with the metastatic status of lymph node,tumor size and stage,otherwise vascular cancer embolus was correlated with 5-year recurrence-free survival rate.Univariate analysis showed that axillary lymph node metastasis,TNM stage,vascular invasion,with radiotherapy or neoadjuvant chemotherapy for elderly triple negative breast cancer patients 5 years local recurrence or distant metastasisrate is higher(p <0.05).However,the positive rate of axillary lymph node,high p53 expression and no chemotherapy had a higher mortality rate of elderly triple negative breast cancer patients(p <0.05).Multivariate analysis showed that lymph node metastasis and p53 expression were independent prognostic factors for 5 year related deaths.Conclusion: Clinicopathological characteristics of elderly women with triple negative breast cancer patients are higher tumor grade,the positive rate of p53 is high,neoadjuvant chemotherapy and postoperative chemotherapy with a high proportion Compared with elderly women with non-triple negative breast cancer patients.Elderly triple negative breast cancer patients 5 years without recurrence and metastasis survival rate and 5 year survival rates were obviously below than non-triple negative breast cancer group.There are statistically significant(p <0.05).Age and comorbidity are not the decisive factors in the choice of treatment and survival prognosis.The stage of lymph node metastasis and p53 positive ratio were independent prognostic factors. |
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