The Analysis Of Diagnosis And Treatment In HER2 Positive Breast Cancer

Objective: The study retrospectively analyzed the incidence,treatment,pathological features and prognosis of HER2 positive breast cancer treated by the Affiliated Hospital of Zunyi Medical College from 2008.01 to 2017.12,and compared the difference between targeted and non-targeted treatment.Methods: Evaluating the diagnosis and treatment of patients with HER2-positive breast cancer treated by Affiliated Hospital of Zunyi Medical College from 2008.01-2017.12.Collecting the application of trastuzumab in HER2-positive patients,and then classifying them into targeted or non-targeted group.The patient's survival status was recorded and the cardiac toxicity before and after the targeted treatment was recorded.Collating and analysing relevant data by statistical methods.Results: A total of 463 patients were enrolled.According to the inclusion and exclusion criteria,181 patients were excluded,282 patients eventually met the criteria,which includs 194 non-targeted cases and 88 trastuzumab cases.The median DFS in non-targeted treatment group was 69.33 months,the targeted treatment group did not reach the median DFS until the last follow-up date,the difference was not statistically significant(P=0.313).The median OS in non-targeted treatment group was 127.3 months,while the trastuzumab group was cut to the last follow-up date,the difference was not statistically significant(P=0.220).After regression analysis,the primary tumor TNM stage(later),pathological type(invasive ductal carcinoma)were independent prognostic factors of DFS in HER2-positive breast cancer(P<0.05).Age<50 years,lymph node metastasis and the use of trastuzumab was an independent prognostic factor for OS(P<0.05).Among the 45 patients included in the cardiotoxicity study,22(48.9%)were ?50 years old,and 23(51.1%)were <50 years old;31 patients(68.9%)had a history of anthracycline use.14 people(31.1%)were not used.Overall,there was no significant change in LVEF values in patients receiving targeted therapy.Cardiac toxicity occurred in only 4(8.9%)patients(They were decreased by ?15% in LVEF compared with baseline during the use of trastuzumab),and 3 of them received anthracycline therapy.No congestive heart failure,cardiac death occurred,and no patients refused to use targeted therapy due to cardiotoxicity.Regardless of age or presence of anthracycline treatment,there was no significant difference in the incidence of cardiotoxicity between the two groups(P>0.05).Conclusion: In the real-world survey,a significant proportion of HER2-positive patients did not choose to receive trastuzumab-targeted therapy.Targeted therapy with trastuzumab has a tendency to prolong survival in HER2 positive breast cancer patients.Age less than 50 years,lymph node metastasis,later tumor stage,pathological type(invasive ductal carcinoma)and rejection of targeted therapy were independent adverse prognostic factors for the survival of HER2-positive breast cancer.Patients can tolerate trastuzumab targeted therapy,but the occurrence of cardiotoxicity should be concerned.The results still need to expand the sample and extend the follow-up time for further study.