ABSTRACT
Objective:To investigate the prognostic value of molecular subtypes in patients with resected invasive breast cancer.Methods:Between 2015 and 2018 7 869 patients with invasive breast cancer after undergoing surgery were included in this analysis. Breast cancer was classified into four subtypes according to the status of hormone receptor (HR) and HER2: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. Kaplan-Meier curves and COX regression were used to compare disease-free survival (DFS) and overall survival (OS) among different subtypes.Results:The 5-year DFS and OS were 86.30% and 94.29%, respectively. Proportions of HR+/HER2-、HR+/HER2+、HR-/HER2+ and HR-/HER2- were 52.9%、17.5%、14.1%和15.5%, respectively. The 5-year DFS of HR+/HER2- subtype (88.12%) was higher than HR+/HER2+ (84.67%, P=0.026), HR-/HER2+ (84.19%, P<0.001) and HR-/HER2- (83.70%, P<0.001). The 5-year OS of HR+/HER2- (95.38%) was not different from HR+/HER2+ (95.17%, P=0.187), while it was higher than that of HR-/HER2+ (92.26%, P<0.001) and HR-/HER2- (91.69%, P<0.001). Subtype was still a significant factor regarding DFS and OS in multivariable analyses adjusting for age, sex, stage, Ki67, types and time of surgery. The DFS ( P=0.257) and OS ( P=0.511) was not different between HR-/HER2+与HR+/HER2- subtypes, while HR-/HER2+ and HR-/HER2- patients had worse DFS ( P<0.05) and OS ( P<0.05) than that with HR+/HER2-. Conclusions:Molecular subtype is a significant independent prognostic factor for DFS and OS in operable invasive breast cancer. HR+ subtypes have better prognosis compared with HR- subtypes. The DFS and OS were not different between HR+/HER2- and HR+/HER2+, or between HR-/HER2+ and HR-/HER2-.
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Objective:To investigate the correlation between ipsilateral metastatic supraclavicular lymph nodes(ISLN) pathologically complete response (spCR) and the prognosis in breast cancer after neoadjuvant chemotherapy(NAC) and lymphadenectomy.Methods:Clinical data of 234 breast cancer patients with ISLN at the time of diagnosis and receiving supraclavicular lymph node dissection following NAC were retrospectively analyzed.Results:All patients were female, with a median age of 52 years. The spCR rate was 52.6%. Multivariate analysis showed that the expression level of Ki67, the pathological status of breast and axillary nodes and the dissection number of supraclavicular lymph node were independent relate factors for spCR (all P<0.05). After a median follow-up of 16.6 months, the risk of recurrence and metastasis in the spCR group was 51%. It was lower than that in the non-spCR group ( HR=0.49, 95% CI 0.27-0.89, P=0.020). It was mainly manifested in hormone receptor negative patients. Supraclavicular spCR was an independent prognostic factor for DFS. Conclusions:The expression level of Ki67, pathological state of breast and axillary node and the dissection number of supraclavicular lymph node were independent related factors of spCR, which was also an independent predictor of DFS.
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Objective To explore the diagnostic value of digital breast tomosynthesis technique (DBT) in breast suspicious calcified lesions.Methods Clinical data of 135 patients using DBT and FFDM (Full field digital mammography) was respectively analyzed.Results Of the 135 cases,43 cases were malignant,and 92 cases were benign.The diagnostic sensitivity DBT and FFDM were 93.0％ (40/43)and 88.4％ (38/43),specificity were 88.0％ (81/92) and 75.0％ (69/92),accuracy were 89.6％ (121/135) and 79.3％ (107/135),the differences were statistically significant (P ＜0.05).The ROC curve area (AUC) of DBT and FFDM were 0.905 ± 0.026 and 0.817 ± 0.034 (P =0.000 2).In premenopausal,postmenopausal and breast density ACR3-4 cases,DBT accuracy is higher than FFDM (P ＜ 0.05).The BI-RADS classification difference of the benign calcified lesions was statistically significant (x2 =11.740,P =0.038 5).Conclusions Compared with the traditional FFDM,DBT has a higher value in the diagnosis of breast suspicious calcified lesions,especially for benign calcified lesions.