Comparative Analysis Of Clinicopathological Features Of Breast Cancer In Young And Middle-aged And Elderly Women

Objective:To analyze and compare the clinicopathological characteristics of breast cancer patients aged 35 and younger and those aged over 35,and to provide theoretical support for the clinical diagnosis and treatment of breast cancer in young women.Method:Retrospectively collected and analyzed the clinical and pathological data of 133 cases of breast cancer in young women aged 35 and younger diagnosed by pathological examination and treated by surgery in the Affiliated Hospital of Taishan Medical College from January 1,2010 to December 31,2018.225 cases of middle-aged and elderly breast cancer patients admitted in the same period were randomly selected as the control group.The two-year-old group was compared in the following two aspects.Analysis.Clinical data include age at menarche,menstrual regularity,frequency of oral contraceptives,age at first birth,number of births,breast feeding,drinking and smoking,family history of breast cancer,quadrant of tumors(upper,lower,outer,lower),volume of tumors,clinical stage and lymph node metastasis.Pathological data included pathological types(carcinoma insitu,invasive ductal carcinoma,invasive lobular carcinoma,invasive micropapillary carcin oma and other rare types),ESBR classification,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor-2(Her-2),and P53 expression.Molecular typing: Luminal A: ER + and/or PR +,Her-2-,Ki67 < 14%;Luminal B: ER + and/or PR +,Her-2-,Ki67 > 14% or ER + and/or sexual PR +,Her-2+,any Ki67;Her-2 overexpression:ER-,PR-,Her-2+;Trinegative: ER-,PR-,Her-2-.SPSS 21.0 statistical software was used to compare and analyze the above factors in two-year-old patients.Result:1.Comparison of clinical features: There were significant differences in clinical hist-ory,including menarche age,oral contraceptives,breastfeeding and alcohol consumption between young and old breast cancer patients(P < 0.001).Young breast cancer patients had earlier menarche age,higher frequency of oral contraceptives and alcohol consumption,fewer births and lower breastfeeding rate.There was significant difference in family history between two-year-old group(P=0.03).Young breast cancer women had a higher proportion of family history.There was no significant difference in tumor quadrant location,tumor volume,lymph node metastasis and clinical stage(P>0.05).2.Comparison of pathological features: The histological grade(grade III)of invasive breast cancer in young group was significantly higher than that in middle-aged and elder group(P < 0.008);the positive expression rate of ER in young group was significantly lower than that in middle-aged and old group(P = 0.024);the proportion of invasive micropapillary carcinoma in young group was lower than that in middle-aged and young group,and the difference was statistically significant;but the expression of PR,Her-2 and P53 in two-year-old group was not significant statistical significance(P > 0.05).3.Molecular typing comparison: The proportion of Luminal A type in invasive breast cancer in young women was significantly lower than that in middle-aged and elderly women(P=0.002);the proportion of Her-2 overexpression type and triple negative breast cancer in young women was significantly higher than that in middle-aged and elderly women(P=0.002);but there was no significant difference in the proportion of Luminal B type in two-year-old women.Conclusion:1.Early menarche age,high frequency of oral contraceptives and alcohol consumption,low Breast-feeding Rate and family history of breast cancer may be risk factors for breast cancer in young women.Menstrual regularity,age at first birth and smoking have little effect on breast cancer in young women.There were no significant differences in the location of tumor quadrant,tumor volume,lymph node metastasis and clinical stage between young and middle-aged women with breast cancer.Compared with breast cancer in middle-aged and old-aged women,invasive breast cancer in young women has higher histological grade,lower ER receptor positive expression rate,lower Luminal A molecular typing ratio,higher Her-2 overexpression and triple negative breast cancer ratio,which indicates that the malignant degree of breast cancer in young women is higher,but the proportion of invasive micropapillary cancer in young women is lower than that in middle-aged and old-aged group.There was no significant difference in the expression of PR,Her-2 and P53 between the two-year-old group.