ABSTRACT
Introduction: Invasive breast cancer is the most common carcinoma in women. Immunohistochemistry classification now plays a key role in prognostic identification and prediction of outcome in this disease. Based on recent gene expression studies, immunohistochemical subtypes are as follows: Luminal A [ER+ and /or PR+, HER2-], luminal B [ER+ and /or PR+, HER2+], HER2+/ ER-, PR-, and basal-like [ER-, PR-, HER2-]. These molecular differences have been shown to correlate with clinical features, such as survival, and sensitivity to treatment. In this study we evaluated the association between different subtypes with histological type, grade, tumor stage, lymph node positive ratio, lymph node status, recurrence, and survival
Patients and methods: We retrieved the clinical records of 580 patients with breast cancer who were treated at Mahdieh Institute of oncology in Hamadan, Iran, between Oct 2004 and Oct 2011, and we evaluated clinicopathological data of these patients
Results: Mean age of patients was 47.22 +/- 11.1 years. Of 573 patients, 116 [20.2%] were ER /PR+, HER2+, 257 [44.9%] were ER /PR+, HER2-, 72 [12.6%] were ER /PR-, HER2+, 124 [21.6%] were ER /PR-, HER2- and 4 were undefined. The estimated median follow up period for all subjects was 4.9 years [range 3 months to 6.9 years]. The overall survival for all patients was 88.21% and the disease free survival was 83.7%. The interesting result of this study was the lower incidence of positive axillary lymph nodes in triple negative subtypes. Five-year relative survival rates were higher for patients with ER/PR+ and negative lymph nodes [p< 0.05]
Conclusion: This study highlighted the importance of immunohistochemical subtypes. As our patients were good representatives of breast cancer in western Iran and this study showed some differences with literature, further research should be directed at standardization of molecular and immunohistochemical methods in our country
ABSTRACT
Cardiovascular damage after Radiotherapy of left chest wall for left breast cancer is a potential fear, therefore studing both the possible causes of radiation-induced heart damage and preventive measures are crucial issues in radiation therapy of breast cancer. The present study investigates noninvasively the possible acute and chronic ECG changes and their incidences after Radiotherapy in patients with left sided breast cancer who have received 6-8 courses of Anthracycline based chemotherapy following mastectomy. 56 patients with breast cancer [invasive ductal carcinoma] who had been undergone modified radical mastectomy, adjuvant Anthracycline based chemotherapy, and left sided chest wall electron therapy with direct field, have been evaluated. All patients investigated with physical examination and standard 12 leads ECG before, and immediately after completion of radiation therapy, and 6 months afterward. New electrocardiographic changes after therapy were seen in 3 patients [5.35%] and reduced to 2 cases [3.57%] after 6 months. there was no significant difference in T wave findings before and after radiation therapy[P=0.521].Also there wasn't any correlation between stage of cancer and any changes in ECG findings after radiation therapy [P=0.56]. There were no clinical cardiac symptoms or signs after Radiotherapy. Most affected leads in ECG were V1-V4 and the main abnormality was Inverted T wave. This findings suggest that the most acute and chronic electrocardiographic effect of irradiation on heart is repolarization abnormality. This study suggests that there are no significant ECG changes after Radiotherapy of left chest wall by electron beam in patients with left sided breast cancer who has received Anthracycline based chemotherapy following mastectomy. Also Radiotherapy by electron doesn't induce any clinical cardiac symptoms and signs in these patients. Therefore, we recommend using electron beam for Radiotherapy of patients with left sided breast cancer after radical mastectomy if Anthracycline based chemotherapy, has been administered