Analysis Of De Novo And Recurrent Metastatic Breast Cancer With HER2-negative

Objective:By comparing the clinicopathological data of HER2-negative de novo metastatic breast cancer(dn MBC)and recurrent metastatic breast cancer(r MBC)patients,to explore the difference in clinicopathological characteristics and prognosis of these two types of patients.Methods:The clinicopathological data of 327 patients with HER2-negative dn MBC and r MBC diagnosed and treated by the Breast Center of the Fourth Hospital of Hebei Medical University from January 2014 to December 2018 were collected,including gender,age of onset,menstrual status,the time of diagnosis,immunohistochemistry,location and number of metastases,treatment and follow-up,which were analyzed using SPSS 25.0statistical analysis software.Results:1.327 cases of HER2-negative advanced breast cancer patients with complete data and successful follow-up were collected,and the median follow-up time was 31 months.Among them,99 cases(30.3%)were dn MBC,and 228 cases(69.7%)had r MBC.According to molecular classification,patients were divided into Luminal A type 70 cases(21.4%),Luminal B type(HER2 negative)193 cases(59.0%)and TNBC type 64 cases(19.6%).2.There was no significant difference in the age of onset,menstrual status and molecular classification between the two groups of patients(P>0.05).ER status,number of metastatic sites,and first metastatic site were significantly different between the two groups(P<0.05).The proportion of ER positive in the dn MBC group was higher(87.9% vs 77.2%),and the proportion of single metastases was higher(76.8% vs 58.3%),and the proportion was higher in the first metastasis site(47.2% vs 31.3%).3.The overall median survival time of the enrolled patients was 54months;the median survival time of patients in the dn MBC group was not reached;the median survival time of patients in the r MBC group was 48 months.The difference was statistically significant(P <0.05).4.The median survival time of Luminal A and Luminal B patients in the dn MBC group is not reached,and the median survival time of TNBC patients is 21 months.The median survival time of Luminal A,Luminal B,and TNBC patients in the r MBC group were 63 months,67 months,and 19 months,respectively.There was no statistically significant difference in the prognosis of the corresponding molecular types between the two groups of patients(P>0.05).5.There were 76 patients(76.8%)with single metastasis in the dn MBC group,and the median survival time was not reached.There were 133 patients(58.3%)with single metastasis in the r MBC group,and the median survival time was 65 months.The difference was statistically significant(P<0.05).6.The median survival time of 52 patients in the dn MBC surgery group is not reached,and the median survival time of 47 patients in the non-surgery group is 31 months.The median survival time of 228 patients in the r MBC group was 48 months.Among them,the prognosis difference between the dn MBC surgery group and the non-surgery group,the dn MBC surgery group and the r MBC group was statistically significant(P<0.05);and the prognosis of the dn MBC non-surgery group and the r MBC group were not statistically different.(P>0.05).7.Comparison of the prognosis of Luminal patients with chemotherapy as the initial treatment regimen.The median survival time of 75 patients in the dn MBC group has not been reached,and the median survival time of 78 patients in the r MBC group is 63 months.The difference is statistically significant(P<0.05).According to comparison of the prognosis of Luminal patients whose initial treatment is endocrine therapy,the median survival time of 9 patients in the dn MBC group was 54 months;and the median survival time of 74 patients in the r MBC group was 67 months.The difference was not statistically significant(P>0.05).8.The age at diagnosis,menstrual status,ER status,number of metastatic sites and groups(dn MBC group and r MBC group)are related to the survival time of patients with advanced breast cancer.Menstrual status,ER status and the number of metastatic sites are related to the survival time of dn MBC breast cancer patients.ER status and the number of metastatic sites are related to the survival time of patients with r MBC breast cancer.ER status and the number of metastatic sites are independent factors affecting the prognosis of patients with advanced breast cancer.Conclusions:1.The patients in the HER2-negative dn MBC group had a higher proportion than that of patients with r MBC breast cancer of ER positive,single metastasis and bone metastasis at the first metastatic site.2.The overall prognosis of patients with HER2-negative dn MBC breast cancer is better than that of patients with r MBC breast cancer.3.The prognosis of patients with single metastasis in the HER2-negative dn MBC group is better than that of patients with single metastasis in the r MBC group.The prognosis of patients in the HER2-negative dn MBC surgery group was better than that of the non-surgery group and patients with r MBC breast cancer.4.The prognosis of dn MBC patients whose initial treatment regimen of Luminal type is chemotherapy is better than that of patients with r MBC breast cancer.5.ER-negative and multiple metastases are independent factors affecting the poor prognosis of patients with HER2-negative advanced breast cancer.