Clinical and pathological characteristics and treatment of elderly patients with breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the clinical and pathological characteristics and treatment patterns and the factors influencing treatments of elderly patients with breast cancer.</p><p><b>METHODS</b>From January 2001 to December 2006, 647 female breast cancer patients over 65 years old were treated. The clinical records were reviewed. All patients were divided into three groups according to age, including 65 to 69 years old group, 70 to 74 years old group and 75 years or elder group. These 647 patients accounted for 13.4% of all breast cancer patients undergoing surgery during the same period. Major pathological type was invasive ductal carcinoma (79.3%). The patients who had chronic comorbid diseases of other systems accounted for 54.7%. Five hundred and eighty-six patients underwent modified radical mastectomy, accounting for 90.6%. Two hundred and thirty-three patients underwent postoperative adjuvant chemotherapy, accounting for 36.0%. The differences of clinicopathological characteristics and treatment patterns between three groups were tested by Chi-square test.</p><p><b>RESULTS</b>Older patients had more tumors with mucinous and other pathological types, less over-expression of Her2/Neu(+++), higher probability to have comorbidities, higher probability to undergo relatively conservative surgery, lower probability to receive postoperative chemotherapy, and higher probability to receive postoperative endocrine therapy alone.</p><p><b>CONCLUSIONS</b>Breast cancer in the elderly exhibits distinctive clinical and pathological characteristics. Treatment patterns they received are related to age.</p>

A study on the relationship between breast cancer molecular classification and prognosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between breast cancer molecular classification and prognosis.</p><p><b>METHODS</b>From January 2002 to December 2003, 708 female primary breast cancer patients with a mean age of 53 years old were retrospectively analyzed. The classification of breast cancer was according to the immunohistochemical results of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2) status. Molecular classification definitions included highly endocrine responsive, incompletely endocrine responsive, triple negative, and HER2 positive. The prognosis among different molecular classifications of breast cancer was investigated. The survival rates of different classifications were compared by Log-rank test.</p><p><b>RESULTS</b>The proportion of highly endocrine responsive, incompletely endocrine responsive, HER2 positive and triple-negative breast cancer was 33.2% (235/708), 23.6% (167/708), 21.3% (151/708) and 21.9% (155/708). The follow-up period were from 3 to 68 months with a median of 40.2 months. A total of 100 cases were identified to had disease recurrence or death. Factors affecting the prognosis were tumor size, axillary lymph node status, molecular classification, adjuvant radiotherapy and adjuvant endocrine therapy by univariate analysis. Multivariate analysis revealed that the molecular classification and lymph node status were the independent prognostic factors with the hazard ratio 1.205 (P = 0.047) and 4.512 (P = 0.000), respectively. Survival analysis showed that highly endocrine responsive breast cancer was with superior prognosis versus others.</p><p><b>CONCLUSIONS</b>Molecular classification of breast cancer is an independent predictor of prognosis. Breast cancer patients classified as highly endocrine responsive subtype have the best outcome.</p>