Clinical Characteristics And Prognosis Of ER,PR,HER-2 Negative Breast Cancer

ObjectiveTo analyze the clinicopathological features,parameters of molecular biology, survival rate, prognostic factors in ER,PR,HER-2 negative breast cancer.MethodsThe data of 515 in our institution were retrospectively analyzed. Using tissue microarray and immunohistochemistry methods, according to the expression of ER,PR,HER-2,we categarized 515 invasive breast cancer into 3 subtypes:other (ER or PR +),triple negative (all ER,PR,HER-2 -),and HER-2(ER-,PR-,HER-2+).Expression of P53,P170,TOP2,Ki67 and GST were assessed immunochemically.The clinicopathological features, Parameters of molecular biology,disease free survival rate and overall survival rate of these three subtype were analyzed.Results1.Clinical and pathological characteristics:88 patients (17%)of 515 patients were identified as TBC, The mean age at diagnosis was significantly younger for the triple negative group compared with other group with a median age of 48.53±9.09(HR group,HER-2 group were 50.60±11.75,52.76±11.69 respectively,P<0.05). The mean tumor size was significantly larger for the triplenegative group compared with other group with a mean tumor size of 3.52±1.36cm (HR group,HER-2 group were 3.32±1.47cm,4.03±1.87cm respectively,P<0.001). TBC was almost ductal carcinoma with a high proliferation rate and p53,P170,Ki67,GST-πover- expression (P<0.05). 2.Relationship between tumor size and node status:Among the triple-negative group,there was no correlation between tumor size and node status. Even the small tumors in the triple negative group had a high rate of node positivity . In the HR group, there was a clear increase in node positivity as tumor size increased;Among the HER-2 group, there was no correlation between tumor size and node status.3.Recurrence and survivalRecurrence time,rate and risk:Median follow-up time was 8.35(2.61-14.67)years to January 1 of 2008 ;21 patients(23.9%)of TBC was suffered relapse. Compared with other women with breast cancer, those with triple-negative breast cancer had an increased likelihood of distant recurrence (hazard ratio, 2.57; 95% confidence interval, 1.50 - 4.43; P < 0.003).Death rate and risk: TBC group death rate was 22.7%( HR group,HER-2 group were 10.3%,8.2%,P<0.05); Compared with other women with breast cancer, those with triple-negative breast cancer had an increased likelihood of death (hazard ratio, 2.64; 95% confidence interval, 1.52-4.59; P < 0.001) within 5 years of diagnosis but not thereafter.ConclusionCompared with non TBC, those with triple-negative breast cancer had those characteristics:younger,larger size,even the small tumors in the triple negative group had a high rate of node positivity,earlier recurrence,higher recurrence,higher death, an increased likelihood of distant recurrence and death within 5 years of diagnosis but not thereafter.