| ObjectiveTo investigate the clinicopathological characteristics,treatment and prognosis factors of Luminal B breast cancer in T1NOM0 stage,and to provide the basis for prognosis and treatment of Luminal type B early breast cancer.MethodsIn the study,clinicopathological data of breast cancer patients who were treated at the Tianjin Medical University Cancer Institute and Hospital were collected from January 2010 to January 2013,and clinicopathological features of 300 patients with T1NOMO Luminal B breast cancer were retrospectively analyzed.To compare the different treatment methods and factors related to prognosis.300 patients were divided into taxane/anthracycline chemotherapy group,taxane combined anthracycline chemotherapy group and no chemotherapy group,and the disease-free survival(DFS)and overall survival(OS)were analyzed to confirm the effect of chemotherapy and chemotherapy regimens on the prognosis.All patients were diagnosed by histopathological examination and immunohistochemical methods were used to test the levels of hormone receptors(ER,PR),Human epidermal growth factor receptor 2(HER-2)and cell proliferation-associated protein(Ki-67)expressed in the patient’s tumor tissues.SPSS software was used for statistical data analysis.The chi-square test was used to compare different clinicopathological data and the Kaplan-Meier method was used to analyze survival.Log-rank test was used to test the survival rate.Multivariate factors of prognosis were analyzed by COX model.P<0.05 was considered statistically significant.ResultsThe onset age of the patients was 20-82 years,with the average age of 52 years.According to the size of the tumor,the patients were divided into T1a,T1b and T1c groups.There were 24 cases(8%)in T1aNOMO,115 cases in T1bNOMO(38.3%),and 161 cases in T1cNOMO(53.7%).Analysis of groups showed that the histological grade of tumor was correlated with the size of tumor.The larger the tumor diameter,the higher the histological grade(P=0.004).The 5-year DFS of all patients was 87.7%and the 5-year OS was 94.7%.The 5-year DFS of Tla,T1b and T1c patients were 95.8%,93.9%and 85.1%,and the 5-year OS were 100%,94.7%and 94.4%.The results of univariate analysis showed that age,histological grade,HER-2,Ki-67 and chemotherapy had an effect on the patient’s DFS(P<0.05),and the expression of HER-2 also affected the 5-year OS of the patients(P<0.05).Multivariate analysis showed that histological grade(P=0.048),chemotherapy(P=0.046),HER-2 expression(P=0.001)and Ki-67(P=0.002)were independent factors of the 5-year DFS of T1NOMO Luminal B breast cancer.The 5-year DFS and OS of the T/A chemotherapy group in the Tla-bNOMO group had no significant difference compared with the TA combined chemotherapy group(P>0.05),while in T1cNOMO,the 5-year DFS of the T/A chemotherapy group was significantly lower than that of the TA combined chemotherapy group(P=0.042),and the 5-years OS was no difference(P=0.711).Univariate analysis showed that chemotherapy cycle affected the 5-year DFS(P=0.009).The 5-year DFS of the 4-6 cycle chemotherapy group was significantly better than that of the 0-3 cycle chemotherapy group(P=0.003)and the 6 cycle chemotherapy group(P=0.029).The OS between the three groups was no difference(P>0.05).ConclusionsThe 5-years DFS of Tla,T1b and T1c is 95.8%,93.9%and 85.1%respectively,5-years OS is 100%,94.7%and 94.4%respectively.Histological grade,HER-2,Ki-67 and chemotherapy are independent prognostic factors for T1NOMO Luminal B breast cancer patients.Tla-bNOMO patients may be administered taxane/anthracycline chemotherapy,while Taxane combined with anthracycline chemotherapy are advised in T1cNOMO patients,and the 5-years DFS is better when the chemotherapy cycle is 4-6 cycles.The study provides the basis for the clinical diagnosis and treatment of T1NOMO Luminal B breast cancer with avoiding over-treatment and improving the quality of life of the patients. |
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