Correlation Analysis Of M&P Grade And Molecular Subtype Evaluation After Neoadjuvant Chemotherapy For Breast Cancer

Objective:Objective to investigate the relationship between Miller & Payne(M & P)classification and prognosis of breast cancer after neoadjuvant chemotherapy.Methods:Choose between January 2011 and January 2014,China medical university cancer hospital,483 cases of neoadjuvant chemotherapy in patients with breast cancer were retrospectively analyzed,according to the immunohistochemical method to detect and determine molecular subtypes of breast cancer,according to the female progesterone receptor(ER,PR)and human epidermal growth factor receptor 2(its ehrs-2)expression of Luminal type,its ehrs-type 2 and three Yin type,according to the pathological reaction after neoadjuvant chemotherapy of breast cancer Miller & Payne,pathological evaluation(M & P),pathologic complete response pCR(G5)group,The 5-year DFS and OS differences between the three groups of Luminal,her-2 and triple-negative breast cancer M&P grades were statistically analyzed by kaplan-meier.Results:483 patients,all female,were diagnosed between 25 and 67 years old,with a median age of 50 years old.Premenopausal 256 cases(53%),227 cases(47%)after menopause,stage II 332 cases(68.7%),? 151 cases(31.2%);In 4-8 cycles of neoadjuvant chemotherapy,416 cases(86.1%)received combined anthracycline and purple shirt chemotherapy,24 cases(4.9%)received chemotherapy with pure purple shirt chemotherapy,and 43 cases(8.9%)received chemotherapy with yew and platinum chemotherapy.There were 452 cases of invasive ductal carcinoma(93.6%),15 cases of invasive lobular carcinoma(3.1%),8 cases of invasive micropapillary carcinoma(1.6%),and 8 cases of mucinous carcinoma(1.6%).There were 239 cases of Luminal type(49.4%),138 cases of her-2 type(28.5%),106 cases of tri-negative type(21.9%),84 cases of pCR(G5),251 cases of G4+G3(51.9%)and 148 cases of G2+G1(30.5%).Luminal,her-2 and tri-negative G5(pCR)rates were 10.4%,19.5% and 30.2%,respectively.Pathological complete response rate(G5)of her-2 and tri-negative group was significantly higher than that of Luminal group(P < 0.05).The 5-year DFS and OS of Luminal,her-2 and tri-yin were 76.9%,61.6%,61.3%,89.5%,71.0% and 78.3%,respectively,with statistically significant differences(P < 0.05).The 5-year DFS and OS of Luminal type were 88.0%,83.6%,65.2%,96.0%,93.4% and 82.6%,respectively,inthe pCR(G5)group,G4+G3 group and G2+G1 group.The 5-year DFS and OS of her-2type were 85.2%,65.0%,38.7%,92.6%,76.3% and 58.1%,respectively.The 5-year DFS and OS of the three negative types were 78.1%,49.0%,32.0%,89.5%,67.3% and 56.0%,respectively.Luminal pathological complete response in pCR(G5)group and the pathological group were markedly improved(G4 + G3)compared with five years DFS(88.0% vs.83.6%),OS(96.0% vs.93.4%)did not see obvious difference(P > 0.05),while its ehrs-type 2 and type three Yin pathological complete response pCR(G5)group,5 years of DFS and OS were superior to the pathological group were markedly improved(G4 + G3)differences statistically significant(P < 0.05).Conclusion:Luminal type is less sensitive to neoadjuvant chemotherapy than her-2 and tri-negative type,but has a good overall prognosis.M & P pathological grading has a good prognostic value for her-2 type and tri-yin type.