The Influence Of Molecular Classification Of Breast Cancer On The Safety Of Breast-conserving Surgery

Objective Research shows that the molecular classification of breast cancer in breast cancer incidence,risk factors,prognosis and treatment are difference,so weather breast cancer molecular classification affect the choice of the breast conserving surgery? Especially for HER2-positive and Triple-negative with poor prognosis.The prognosis of breast cancer patients with breast conserving surgery was analyzed,and the risk factors of tumor recurrence,metastasis and survival were discussed and to analyze the relationship between the breast cancer molecular classification and the prognosis and to discuss the safety of the breast conserving surgery and the choice of operation in terms of breast cancer molecular classification.Methods Clinical data of 694 patients with breast-conserving therapy in Tianjin Medical University Cancer Institute and Hospital from August 2005 to August 2010 were analyzed retrospectively.Univariate analysis included age,molecular classification,family history,menopausal status,pathological T stage,lymph node metastasis,margin status,calcification,histological grade,pathological type,chemotherapy,radiotherapy,ER/PR state and endocrine therapy,the meaningful of which were in multivariate analysis.According to molecular classification when breast cancer was diagnosed,patients were subdivided into five groups:Luminal A,Luminal B1,Luminal B2,HER2-positive,Triple-negative.Clinicopathological characteristics and survival were compared between five groups.Results Risk factors of breast conserving surgery include lymph node metastasis > 3,tumor volume>2 cm,margin positive,no radiotherapy,ER/PR(-)or ER/PR(+)with no endocrine therapy.Of the patients,148 cases were Luminal A,231 cases were Luminal B1,63 cases were Luminal B2,40 cases were HER2-positive and 136 cases were Triple-negative.The 5-year local regional recurrence-free survival rates were 99.3%,98.7%,98.4%,94.9% and 95.9% respectively(P>0.05)and the 5-year distant metastasis-free survival rates were 97.3%,95.7%,93.7%,87.5% and 91.4% respectively(P<0.05)and the 5-year over-all survival rates were 98.6%,97.8%,98.4%,92.5% and 95.6% respectively(P>0.05)for patients with Luminal A,Luminal B1,Luminal B2,HER2-positive,Triple-negative.Multivariate analysis showed that 5-year distant metastasis risk were significantly increased in patients with HER2-positive and Triple-negative(P < 0.05),while 5-year local regional relapse risks and 5-year mortality risk was not increased(P>0.05).Conclusion After breast-conserving therapy,Risk factors associated with breast cancer include molecular typing,age,edge status,pathological T staging,number of lymph node metastases,radiotherapy,chemotherapy,ER/PR status & endocrine therapy.The risk of 5-year local regional recurrence risk and mortality risk are not relatively higher in patients with HER2-positive and triple-negative breast cancer patients,so they can accept the breast conserving surgery.The breast cancer molecular classification can not influence the safety of the breast conserving surgery.