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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 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.
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Objective To evaluate the diagnostic value of breast mass-like lesions by digital breast tomosynthesis technique (DBT) versus full field digital mammography (FFDM).Methods 182 breast mass cases undergoing respectively DBT and FFDM diagnosis were reviewed to evaluate the the sensitivity,specificity and accuracy,breast BI-RADS classification and differences of edge character.Results Of the 182 cases,101 cases were malignant,81 cases were benign.DBT and FFDM in malignant mass detection rate were 95.0％ and 95.0％ respectively,the benign tumor detection rate were 80.2％ and 80.2％ respectively,the difference was statistically significant (P ＜ 0.05).The diagnostic sensitivity was 93.1％ (94/101) and 82.2％ (83/101),specificity was 66.7％ (54/81) and 53.1％ (43/81),accuracy was 81.3％ (148/182) and 69.2％ (126/182),all the differences were statistically significant (P ＜ 0.05).The BI-RADS classification difference of the malignant mass was statistically significant (x2 =12.912,P =0.044 5),and the benign mass was also statistically significant (x2 =12.739,P =0.026 0).The clear edge benign tumors detected by DBT and FFDM respectively were 65 and 45 cases (x2 =10.224,P =0.001 4).The spicule sign detected by DBT and FFDM respectively in malignant tumors were 71 and 50 cases (x2 =8.244,P =0.004 1).Conclusion DBT compared to traditional FFDM photography improves the lesion visibility,increases the diagnostic sensitivity and specificity,conducing to the identification of benign and malignant lesions.
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<p><b>OBJECTIVE</b>To investigate the predictive factors affecting sentinel lymph node status in early breast cancer patients.</p><p><b>METHODS</b>Clinicopathological data of 1 038 patients with early breast cancer, who underwent sentinel lymph node biopsy in Henan Tumor Hospital between July 2010 and August 2013, were reviewed. Logistic regression analysis was performed to identify the relevance of clinicopathological features with sentinel lymph node metastases.</p><p><b>RESULTS</b>This group was consisted of 1 038 female patients with an average of 48.6 years. Positive sentinel lymph nodes were found in 22.9% (238/1 038) of the patients. The average number of sentinel lymph nodes removed by surgery was 3.8. Tumor size, tumor location, histopathology, ER/PR status and Ki-67 level were significantly correlated with SLN metastasis(P < 0.05 for all). All the above factors but Ki-67 level were significant independent predictors for SLN metastasis(P < 0.01 for all).</p><p><b>CONCLUSION</b>Negative hormone receptor status, invasive cancer of non-specific histopathological type, tumor size >2 cm, and tumor location in the outer upper quadrat are independent predictive factors of sentinel lymph node metastasis in patients with early breast cancer.</p>
